Body Fat Ratio as a Novel Predictor of Complications and Survival After Rectal Cancer Surgery

Abstract

Aim To investigate the relationship between body fat ratio (BFR), visceral fat area (VFA), body mass index (BMI), and visceral fat density (VFD) and to assess their reliability in predicting the risk of postoperative complications and survival status in patients with rectal cancer (RC). Methods The study prospectively included 460 patients who underwent surgical treatment for RC at the First Affiliated Hospital of Wannan Medical College between September 2018 and July 2021. BFR, VFA, BMI, and VFD were measured, and patients' basic information, clinical data, complications, and survival were recorded. Statistical analysis was performed to determine the optimal BFR cutoff and elucidate group differences. Results BFR exhibited significant correlations with VFA (R = 0.739), BMI (R = 0.783), and VFD (R = -0.773; all P < 0.05). The area under the receiver operating characteristic curve of BFR, VFA, BMI, and VFD in predicting postoperative complications were all > 0.7, with an optimal BFR cutoff value of 24.3. Patients in the BFR-low group had fewer postoperative complications and lower intraoperative indices, hospitalization times, and costs (P < 0.05) compared to the BFR-high group. BFR predicted complications with high diagnostic significance and was validated by multiple models. Patients in the BFR-high group had better survival than those in the BFR-low group (P < 0.05). Conclusion BFR is closely related to BMI, VFA, and VFD. Reasonable control of BFR or a modest increase may help prevent and treat postoperative complications of RC and improve patients’ long-term survival.