Analytic morphometric assessment of patients undergoing colectomy for colon cancer

J Surg Oncol. 2013 Sep;108(3):169-75. doi: 10.1002/jso.23366. Epub 2013 Jul 11.

Abstract

Background: Analytic morphometrics provides objective data that may better stratify risk. We investigated morphometrics and outcome among colon cancer patients.

Methods: An IRB-approved review identified 302 patients undergoing colectomy who had CT scans. These were processed to measure psoas area (PA), density (PD), subcutaneous fat (SFD), visceral fat (VF), and total body fat (TBF). Correlation with complications, recurrence, and survival were obtained by t-tests and linear regression models after adjusting for age and Charlson index.

Results: The best predictor of surgical complications was PD. PMH, Charlson, BMI, and age were not significant when PD was considered. SF area was the single best predictor of a wound infection. While all measures of obesity correlated with outcome, TBF was most predictive. Final multivariate Cox models for survival included age, Charlson score, nodal positivity, and TBF.

Conclusions: Analytic morphometric analysis provided objective data that stratified complications and outcome better than age, BMI, or co-morbidities.

Keywords: colectomy; colon cancer; morphometric; obesity; sarcopenia.

MeSH terms

  • Adipose Tissue / anatomy & histology
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Mass Index
  • Colectomy / adverse effects*
  • Colonic Neoplasms / pathology
  • Colonic Neoplasms / surgery*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Postoperative Complications / etiology
  • Proportional Hazards Models
  • Sarcopenia / etiology