Visceral adiposity and cancer survival: a review of imaging studies

Xiao, Jingjie; Mazurak, Vera C.; Olobatuyi, Taiwo A.; Caan, Bette J.; Prado, Carla M.

doi:10.1111/ecc.12611

Cited by 75 publications

(54 citation statements)

References 60 publications

(122 reference statements)

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“…According to a recent review of 22 studies of CT determined VAT and cancer survival, greater VAT tended to be associated with poor survival among those with colorectal and pancreatic cancers, but improved survival among those with kidney cancer. 24 However, our observation that greater VAT was related to poor survival among only women with stage II, but not stage III, breast cancer is not corroborated by the only report among women with breast cancer, limited to those with advanced stage disease, that found an positive association between VAT and mortality. 23 …”

Section: Discussioncontrasting

confidence: 81%

Adipose Tissue Distribution and Survival Among Women with Nonmetastatic Breast Cancer

Bradshaw

Feliciano

Prado

et al. 2019

Obesity

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OBJECTIVE: Previous studies of breast cancer survival have not considered specific depots of adipose tissue such as subcutaneous adipose tissue (SAT) and visceral adipose tissue (VAT). METHODS: We assessed these relationships among 3,235 women with stage II/III breast cancer diagnosed between 2005–2013 at Kaiser Permanente Northern California and 2000–2012 at the Dana Farber Cancer Institute. SAT and VAT areas (cm2) were calculated from routine CT scans within 6 (median: 1.2) months of diagnosis, covariates were collected from electronic health records, and vital status was assessed by death records. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox regression. RESULTS: SAT and VAT ranged from 19.0–891 cm2 and 0.484–454 cm2, respectively. SAT was related to increased risk of death [127 cm2 increase, HR (95% CI): 1.13 (1.02, 1.26)] but no relationship with VAT [78.18 cm2 increase: 1.02 (0.91, 1.14)]. An association with VAT was noted among women with stage II cancer [stage II: 1.17 (0.99, 1.39); stage III: 0.90 (0.76, 1.07); p-interaction: <0.01]. Joint increases in SAT and VAT were associated with mortality above either alone [simultaneous 1-SD increase: 1.19 (1.05, 1.34)]. CONCLUSIONS: SAT may be an underappreciated risk factor for breast cancer-related death.

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Section: Discussioncontrasting

confidence: 81%

Adipose Tissue Distribution and Survival Among Women with Nonmetastatic Breast Cancer

Bradshaw

Feliciano

Prado

et al. 2019

Obesity

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“…sICAM-1 is associated with obesity and hyperinsulinemia [ 34 ], and exposure to sICAM-1 stimulates tumor growth [ 35 ], and the inhibition of sICAM-1 attenuates colonic tumor cell invasion [ 36 ]. These in vivo and preclinical data are supported by prospective cohort studies that suggest higher BMI and visceral obesity [ 16 , 18 ], hyperinsulinemia [ 17 ], and elevated sICAM-1 [ 37 ] are associated with recurrence and survival among patients with colon cancer. Exercise reduces visceral obesity in linear dose-response fashion [ 19 ], and insulin and sICAM-1 are reduced in nonlinear fashion [ 20 , 23 ].…”

Section: Discussionmentioning

confidence: 81%

“…In addition, patient or host characteristics related to energy balance [ 14 ], such as obesity and hyperinsulinemia, may create an environment that is plentiful in growth factors and impaired immune surveillance necessary to promote the survival and proliferation of CTCs [ 15 ], perhaps explaining why states of obesity and hyperinsulinemia are associated with disease recurrence and mortality [ 16 – 18 ]. Exercise reduces visceral obesity and insulin among patients with colon cancer [ 19 , 20 ].…”

Section: Introductionmentioning

confidence: 99%

Effects of exercise on circulating tumor cells among patients with resected stage I-III colon cancer

et al. 2018

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BackgroundPhysical activity is associated with a lower risk of disease recurrence among colon cancer patients. Circulating tumor cells (CTC) are prognostic of disease recurrence among stage I-III colon cancer patients. The pathways through which physical activity may alter disease outcomes are unknown, but may be mediated by changes in CTCs.MethodsParticipants included 23 stage I-III colon cancer patients randomized into one of three groups: usual-care control, 150 min∙wk-1 of aerobic exercise (low-dose), and 300 min∙wk-1 of aerobic exercise (high-dose) for six months. CTCs from venous blood were quantified in a blinded fashion using an established microfluidic antibody-mediated capture device. Poisson regression models estimated the logarithmic counts of CTCs.ResultsAt baseline, 78% (18/23) of patients had ≥1 CTC. At baseline, older age (−0.12±0.06; P = 0.04), lymphovascular invasion (0.63±0.25; P = 0.012), moderate/poor histology (1.09±0.34; P = 0.001), body mass index (0.07±0.02; P = 0.001), visceral adipose tissue (0.08±0.04; P = 0.036), insulin (0.06±0.02; P = 0.011), sICAM-1 (0.04±0.02; P = 0.037), and sVCAM-1 (0.06±0.03; P = 0.045) were associated with CTCs. Over six months, significant decreases in CTCs were observed in the low-dose (−1.34±0.34; P<0.001) and high-dose (−1.18±0.40; P = 0.004) exercise groups, whereas no significant change was observed in the control group (−0.59±0.56; P = 0.292). Over six months, reductions in body mass index (−0.07±0.02; P = 0.007), insulin (−0.08±0.03; P = 0.014), and sICAM-1 (−0.07±0.03; P = 0.005) were associated with reductions in CTCs. The main limitations of this proof-of-concept study are the small sample size, heterogenous population, and per-protocol statistical analysis.ConclusionExercise may reduce CTCs among stage I-III colon cancer patients. Changes in host factors correlated with changes in CTCs. Exercise may have a direct effect on CTCs and indirect effects through alterations in host factors. This hypothesis-generating observation derived from a small pilot study warrants further investigation and replication.

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“…One recent review of the literature that analyzes the influence of VF and cancer survival encountered 6 papers of CRC patients, and only 4 of these papers related VF to survival [24]. Another review concluded that the increase in adiposity was associated with an increase of CC-related mortality and decreased the disease-free survival of CC in women and RC in men [25].…”

Section: Discussionmentioning

confidence: 99%

Influence of Visceral Fat in the Outcomes of Colorectal Cancer

et al. 2018

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Aim: To determine the relationship of visceral fat (VF) with the surgical outcome of the patients with colorectal cancer (CRC) submitted to curative surgery. Methods: Retrospective analysis of all patients submitted to CRC surgery during 3 years with a minimum of 5 years of follow-up. We assessed the length of hospital stay, complications, pathologic reports, surgical re-interventions and hospital re-admissions, relapses, survival time and disease-free time. VF was calculated based on patients’ pre-operative CT-scan. The patients were divided into quartiles according to the VF area. Linear regression models and logistic regression models were used to establish a relationship between VF and all data collected. Results: The study included 199 patients (129 with colon cancer [CC] and 70 with rectal cancer). The average area of VF was 115.7 cm². Patients with CRC revealed a direct relationship between VF and postoperative complications (p = 0.043), anastomotic leakage (p = 0.009) and re-operation (p = 0.005). The subgroup of patients with CC had an inverse association between VF and lymph nodes harvested (p = 0.027). Survival analyses did not reveal significant differences. Conclusion: VF has an influence on postoperative complications, anastomotic leakage and re-operation. A negative influence of VF on lymph nodes harvested was observed on CC patients.

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Visceral adiposity and cancer survival: a review of imaging studies

Cited by 75 publications

References 60 publications

Adipose Tissue Distribution and Survival Among Women with Nonmetastatic Breast Cancer

Adipose Tissue Distribution and Survival Among Women with Nonmetastatic Breast Cancer

Effects of exercise on circulating tumor cells among patients with resected stage I-III colon cancer

Influence of Visceral Fat in the Outcomes of Colorectal Cancer

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