A retrospective study on the relationship between different body weight and surgical outcome in patients undergoing radical resection of colorectal cancer

doi:10.3877/cma.j.issn.1674-3946.2021.03.016

Abstract

Abstract:

Objective

To investigate the relationship between body weight and surgical outcome in patients undergoing radical resection of colorectal cancer.

Methods

From January 2010 to October 2014, clinical data of 246 patients who underwent radical resection of colorectal cancer were analyzed retrospectively. All enrolled patients received radical resection of colorectal cancer and were followed up for 5 years until November 2019. According to body mass index (BMI), the patients were divided into normal group, super recombination group and obesity group, 96 cases, 80 cases and 70 cases respectively. Statistical analysis were performed by using SPSS 22.0 software. Kaplan-Meier survival analysis method was used for the 5-year disease-free survival rate (DFS) of patients. BMI and clinically relevant data were analyzed by using Cox regression.

Results

The 5-year DFS was 78.13% (75/96), 62.05% (50/80) and 55.71% (39/70) in the normal group, the super recombination group and the obese group respectively. Cox regression analysis showed that high BMI, positive preoperative CEA, low differentiation, high pT staging and high pN staging were risk factors for prognosis of colorectal cancer patients after radical resection (P<0.05), and postoperative chemoradiotherapy was a protective factor for prognosis (P<0.05).

Conclusion

Obesity is a major risk factor of poor prognosis in patients with colorectal cancer.

Key words: Colorectal neoplasms, Body mass index, Prognosis

Fuquan Jiang, Peiming Sun, Hongfeng Yan, Xiaomin Sun, Jianwu Yan, Manku Dong, Heming Yang, Chenglin Li, Yan Cui. A retrospective study on the relationship between different body weight and surgical outcome in patients undergoing radical resection of colorectal cancer[J]. Chinese Journal of Operative Procedures of General Surgery(Electronic Edition), 2021, 15(03): 290-293.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://zhpwkssxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1674-3946.2021.03.016

https://zhpwkssxzz.cma-cmc.com.cn/EN/Y2021/V15/I03/290

Figures/Tables 4

References 13

[1]	琚静，韩存芝，昝丽坤，等. 胰岛素样生长因子1及其受体在结直肠癌中的表达及其意义[J]. 肿瘤研究与临床，2017，29(9): 593-597.
[2]	Bender U, Rho YS, Barrera I，et al. Adjuvant therapy for stages II and III colon cancer: risk stratification, treatment duration, and future directions[J]. Curr Oncol，2019，26(Suppl 1): S43-S52.
[3]	Shaukat A, Dostal A, Menk J，et al. BMI Is a Risk Factor for Colorectal Cancer Mortality[J]. Dig Dis Sci，2017，62(9): 2511-2517.
[4]	Veloso GGV, Franco OH, Ruiter R，et al. Baseline Dietary Glutamic Acid Intake and the Risk of Colorectal Cancer: The Rotterdam Study[J]. Cancer，2016，122(6): 899-907.
[5]	Kocarnik JM, Hua X, Hardikar S，et al. Long-term Weight Loss After Colorectal Cancer Diagnosis Is Associated With Lower Survival: The Colon Cancer Family Registry[J]. Cancer，2017，123(23): 4701-4708.
[6]	Martinez-Useros J, Garcia-Foncillas J. Obesity and Colorectal Cancer: Molecular Features of Adipose Tissue[J]. J Transl Med，2016，14: 21.
[7]	王勇，雷静，韩丹. 原始数据迭代重建技术与单能谱成像技术在结直肠癌CT图像重建中联合应用效果[J]. 山东医药，2017，57(39): 88-90.
[8]	Feliciano EC, Chen WY. Clinical Implications of Low Skeletal Muscle Mass in Early-Stage Breast and Colorectal Cancer[J]. Proc Nutr Soc，2018，77(4): 382-387.
[9]	冷霞，王芳军，周培，等. 外周血SEPT9基因甲基化检测联合糖蛋白肿瘤标志物在结直肠癌诊断中的应用[J]. 胃肠病学，2019, 24(6): 362-365.
[10]	倪宇，徐洪雨. 肥胖与结直肠腺瘤和结直肠癌关系的研究[J]. 胃肠病学和肝病学杂志，2019, 28(5): 499-502.
[11]	孙淼，江波，张鑫. 代谢综合征与结直肠癌关系的研究进展[J]. 中华全科医师杂志，2016, 15(11): 889-892.
[12]	卢亚琼，袁文臻，郝建朋. 肥胖与结直肠癌预后关系的研究进展[J]. 临床与病理杂志，2017, 37(7): 1541-1545.
[13]	Roslan NH, Makpol S, Mohd Yusof YA. A Review on Dietary Intervention in Obesity Associated Colon Cancer[J]．Asian Pac J Cancer Prev，2019，20(5): 1309-1319.

项目		正常组(n＝96)	超重组(n＝80)	肥胖组(n＝70)	χ²	P
性别
	男	46(47.9)	41(51.3)	33(47.1)	0.299	0.861
	女	50(52.1)	39(48.8)	37(52.9)	0.299	0.861
年龄
	<70岁	70(72.9)	45(56.3)	28(40.0)	18.194	<0.001
	≥70岁	26(27.1)	35(43.8)	42(60.0)	18.194	<0.001
术前CEA
	阳性	30(31.3)	21(26.3)	20(28.6)	0.535	0.765
	阴性	66(68.8)	59(73.8)	50(71.4)	0.535	0.765
肿瘤部位
	结肠	76(79.2)	44(55.0)	37(52.9)	16.131	<0.001
	直肠	20(20.8)	36(45.0)	33(47.1)	16.131	<0.001
肿瘤大小
	<5 cm	56(58.3)	45(56.3)	40(57.1)	0.079	0.961
	≥5 cm	40(41.7)	35(43.7)	30(42.9)	0.079	0.961
组织类型
	腺癌	80(83.3)	70(87.5)	55(78.6)	2.143	0.343
	其他	16(16.7)	10(12.5)	15(21.4)	2.143	0.343
分化程度
	高分化	26(27.1)	19(23.6)	17(24.3)	0.931	0.920
	中分化	50(52.1)	40(50.0)	35(50.0)
	低分化	20(20.8)	21(26.3)	18(25.7)
pT分期
	T1	8(8.3)	8(10.0)	5(7.1)	5.875	0.437
	T2	22(22.9)	11(13.8)	10(14.3)
	T3	30(31.3)	20(25.0)	20(28.6)
	T4	36(37.5)	41(51.3)	35(50.0)
pN分期
	N0	57(59.4)	43(53.8)	35(50.0)	1.821	0.769
	N1	32(33.3)	30(37.5)	30(42.9)
	N2	7(7.3)	7(8.8)	5(7.1)

项目		正常组(n＝96)	超重组(n＝80)	肥胖组(n＝70)	χ²	P
性别
	男	46(47.9)	41(51.3)	33(47.1)	0.299	0.861
	女	50(52.1)	39(48.8)	37(52.9)	0.299	0.861
年龄
	<70岁	70(72.9)	45(56.3)	28(40.0)	18.194	<0.001
	≥70岁	26(27.1)	35(43.8)	42(60.0)	18.194	<0.001
术前CEA
	阳性	30(31.3)	21(26.3)	20(28.6)	0.535	0.765
	阴性	66(68.8)	59(73.8)	50(71.4)	0.535	0.765
肿瘤部位
	结肠	76(79.2)	44(55.0)	37(52.9)	16.131	<0.001
	直肠	20(20.8)	36(45.0)	33(47.1)	16.131	<0.001
肿瘤大小
	<5 cm	56(58.3)	45(56.3)	40(57.1)	0.079	0.961
	≥5 cm	40(41.7)	35(43.7)	30(42.9)	0.079	0.961
组织类型
	腺癌	80(83.3)	70(87.5)	55(78.6)	2.143	0.343
	其他	16(16.7)	10(12.5)	15(21.4)	2.143	0.343
分化程度
	高分化	26(27.1)	19(23.6)	17(24.3)	0.931	0.920
	中分化	50(52.1)	40(50.0)	35(50.0)
	低分化	20(20.8)	21(26.3)	18(25.7)
pT分期
	T1	8(8.3)	8(10.0)	5(7.1)	5.875	0.437
	T2	22(22.9)	11(13.8)	10(14.3)
	T3	30(31.3)	20(25.0)	20(28.6)
	T4	36(37.5)	41(51.3)	35(50.0)
pN分期
	N0	57(59.4)	43(53.8)	35(50.0)	1.821	0.769
	N1	32(33.3)	30(37.5)	30(42.9)
	N2	7(7.3)	7(8.8)	5(7.1)

变量	B	SE	Wald	P值	HR	95%置信区间
年龄	0.197	0.442	0.181	0.604	1.138	0.443～2.924
性别	0.281	0.441	0.373	0.482	1.248	0.487～3.195
术前CEA	1.503	0.398	3.900	0.039	1.737	1.043～4.060
肿瘤部位	1.282	0.518	0.615	0.612	1.707	0.227～8.204
肿瘤大小	0.181	0.406	0.166	0.555	1.446	0.407～2.687
组织类型	0.258	0.405	0.343	0.443	1.547	0.448～2.936
分化程度	1.698	0.409	5.679	0.029	1.963	1.122～4.691
pT分期	1.379	0.516	6.548	0.007	1.205	1.068～8.617
pN分期	1.267	0.474	6.018	0.006	1.188	1.374～8.469
癌结节	0.237	0.372	0.315	0.407	1.054	0.412～4.698
术后放化疗	-1.270	0.505	5.443	0.034	1.347	1.058～3.962
BMI	1.571	0.263	4.326	0.028	1.709	1.876～4.994

变量	B	SE	Wald	P值	HR	95%置信区间
年龄	0.197	0.442	0.181	0.604	1.138	0.443～2.924
性别	0.281	0.441	0.373	0.482	1.248	0.487～3.195
术前CEA	1.503	0.398	3.900	0.039	1.737	1.043～4.060
肿瘤部位	1.282	0.518	0.615	0.612	1.707	0.227～8.204
肿瘤大小	0.181	0.406	0.166	0.555	1.446	0.407～2.687
组织类型	0.258	0.405	0.343	0.443	1.547	0.448～2.936
分化程度	1.698	0.409	5.679	0.029	1.963	1.122～4.691
pT分期	1.379	0.516	6.548	0.007	1.205	1.068～8.617
pN分期	1.267	0.474	6.018	0.006	1.188	1.374～8.469
癌结节	0.237	0.372	0.315	0.407	1.054	0.412～4.698
术后放化疗	-1.270	0.505	5.443	0.034	1.347	1.058～3.962
BMI	1.571	0.263	4.326	0.028	1.709	1.876～4.994

变量	B	SE	Wald	P值	HR	95%置信区间
术前CEA	1.381	0.366	3.584	0.036	1.596	1.103～4.779
分化程度	1.560	0.376	5.219	0.027	1.804	1.101～4.659
pT分期	1.267	0.474	6.018	0.006	1.107	1.043～5.231
pN分期	1.164	0.436	5.531	0.006	1.092	1.124～6.325
术后放化疗	-1.167	0.464	5.002	0.031	1.238	1.068～5.392
BMI	1.444	0.242	3.976	0.026	1.571	1.048～4.775

Please choose a citation manager

Content to export