Quantitative Assessment of Visceral Obesity and Postoperative Colon Cancer Outcomes

J Gastrointest Surg. 2017 Mar;21(3):534-542. doi: 10.1007/s11605-017-3362-9. Epub 2017 Jan 18.


Background: Quantitative computed tomography (CT) assessment of visceral adiposity may be superior to body mass index (BMI) as a predictor of surgical morbidity. We sought to examine the association of CT measures of obesity and BMI with short-term postoperative outcomes in colon cancer patients.

Methods: In this retrospective study, 110 patients treated with colectomy for stage I-III colon cancer were classified as obese or non-obese by preoperative CT-based measures of adiposity or BMI [obese: BMI ≥ 30 kg/m2, visceral fat area (VFA) to subcutaneous fat area ratio (V/S) ≥0.4, and VFA > 100 cm2]. Postoperative morbidity and mortality rates were compared.

Results: Obese patients, by V/S and VFA but not BMI, were more likely to be male and have preexisting hypertension and diabetes. The overall complication rate was 25.5%, and there were no mortalities. Obese patients by VFA (with a trend for V/S but not BMI) were more likely to develop postoperative complications as compared to patients classified as non-obese: VFA (30.5 vs.10.7%, p = 0.03), V/S (29.2 vs. 9.5%, p = 0.05), and BMI (32.4 vs. 21.9%, p = 0.23).

Conclusions: Elevated visceral obesity quantified by CT is associated with the presence of key metabolic comorbidities and increased postoperative morbidity and may be superior to BMI for risk stratification.

Keywords: Colon cancer; Computed tomography; Surgical complication; Visceral obesity.

MeSH terms

  • Aged
  • Body Mass Index
  • Colectomy / adverse effects
  • Colectomy / statistics & numerical data*
  • Colonic Neoplasms / complications
  • Colonic Neoplasms / surgery*
  • Comorbidity
  • Female
  • Humans
  • Intra-Abdominal Fat / diagnostic imaging
  • Male
  • Middle Aged
  • Obesity, Abdominal / complications
  • Obesity, Abdominal / diagnostic imaging*
  • Retrospective Studies
  • Risk Assessment
  • Risk Factors
  • Subcutaneous Fat / diagnostic imaging
  • Tomography, X-Ray Computed
  • Treatment Outcome