Visceral Obesity and Colorectal Cancer: Are We Missing the Boat with BMI?

Rickles, Aaron S.; Iannuzzi, James C.; Mironov, Oleg; Deeb, Andrew–Paul; Sharma, Abhiram; Fleming, Fergal J.; Monson, J. R. T.

doi:10.1007/s11605-012-2045-9

Cited by 137 publications

(135 citation statements)

References 35 publications

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“…Furthermore, regardless of BMI, women appear to have higher levels of SFA and fat mass than men. 8,10,16,17,28 Similarly, in the current study the correlation between BMI and VFA (r = 0.542) was relatively weak when compared to that of BMI and SFA (r = 0.804) and BMI and TFA (r = 0.846). In addition, women had higher SFA but lower VFA than men, but did not differ from men with regard to BMI or TFA.…”

Section: Discussionsupporting

confidence: 50%

“…6 Visceral fat has been identified as an independent risk factor and a predictor of outcome in several cancers, including breast, esophageal, colorectal and pancreatic cancers. [7][8][9][10][11] Altered metabolism has a central role in RCC pathogenesis, possibly explaining the link between obesity and RCC. 4,12 While the reported effects of BMI on RCC have been uniform, reports concerning the effect of visceral adiposity on the pathological and clinical outcomes of RCC are inconsistent.…”

Section: Introductionmentioning

confidence: 99%

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Association between visceral and subcutaneous adiposity and clinicopathological outcomes in non-metastatic clear cell renal cell carcinoma

Hakimi

Zabor

Bury

et al. 2014

CUAJ

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Introduction: Visceral adiposity has been inconsistently associated with clinicopathologic features and outcomes of clear cell renal cell carcinoma (ccRCC); however, most studies were conducted in non-Western populations. We evaluated the associations between visceral and subcutaneous adiposity and clinicopathological characteristics of non-metastatic ccRCC patients in a Western population. Methods: The medical records of 220 surgically treated ccRCC patients with documented preoperative body mass index (BMI) and computed tomography (CT) scans were retrospectively reviewed. Nineteen patients with stage IV disease were excluded. Visceral (VFA) and subcutaneous fat area (SFA) were computed from preoperative CT scans. Correlations between obesity measures were assessed with Pearson correlation. Associations between obesity measures and pathologic features were evaluated using logistic regression models adjusted for sex. Overall survival (OS) probabilities were estimated using Cox regression analysis. The log-rank test was used for group comparisons. Results: The study cohort comprised 150 men and 51 women. Women had higher SFA (p = 0.01) but lower VFA (p < 0.001) than men. BMI was highly correlated with SFA (r = 0.804) and moderately correlated with VFA (r = 0.542). SFA and VFA were weakly correlated (r = 0.367). An increased BMI was associated with a better OS (p = 0.028). When adjusting for sex, neither SFA nor VFA was significantly associated with tumour grade, stage, or OS. Conclusions: Consistent with prior reports, our study suggests that increased BMI is associated with a better OS for patient with nonmetastatic ccRCC. Despite the high correlation between SFA and BMI, neither SFA nor VFA were significantly associated with tumour stage, grade, or OS in the current study; however, further studies in larger cohorts are required to validate this finding.

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Section: Discussionsupporting

confidence: 50%

Section: Introductionmentioning

confidence: 99%

Association between visceral and subcutaneous adiposity and clinicopathological outcomes in non-metastatic clear cell renal cell carcinoma

Hakimi

Zabor

Bury

et al. 2014

CUAJ

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“…Furthermore, BMI, frequently associated with dyslipidemia [1], was not sensitive for differences in lipid plasmatic profile. Apart from the fact that BMI-defined obesity has missed the detection of subclinical inflammation in our study, it has also been reported that visceral fat measurements elucidate relationships between obesity and cancer otherwise not significant when evaluated by BMI [43]. …”

Section: Discussionmentioning

confidence: 70%

Predictors of Subclinical Inflammatory Obesity: Plasma Levels of Leptin, Very Low-Density Lipoprotein Cholesterol and CD14 Expression of CD16+ Monocytes

Leite

Santos

et al. 2017

Obes Facts

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Objective: Predictors of subclinical inflammatory obesity (SIO) can be important tools for early therapeutic interventions in obesity-related comorbidities. Waist circumference (WC) and BMI have different SIO sensitivity. We aimed to i) identify SIO predictors and ii) investigate whether CD16+ monocytes are associated with BMI- (generally) or WC-defined (centrally) obesity. Methods: Anthropometric and metabolic/endocrine (namely catecholamines, adrenaline and noradrenaline) parameters were evaluated, and CD16+ monocytes were studied by flow cytometry in the peripheral blood from 63 blood donors, and compared and correlated to each other. Multiple linear regression analysis was performed to identify variables that best predict SIO. Results: CD16+ monocyte counts were similar in BMI and WC groups. CD16+ monocytes from centrally obese (CO) showed a more inflammatory pattern, as compared to non-CO subjects. WC was sensitive to lipidemia and, in CO subjects, lipidemia was associated with a more inflammatory phenotype of CD16+ monocytes. These differences were not noticed between BMI groups. Adrenaline was correlated with CD16+ monocyte expansion with a lower inflammatory pattern. Leptin, very low-density lipoprotein cholesterol (VLDL-C), and CD14 expression of CD16+ monocytes were found to be CO predictors. Conclusions: WC-, but not BMI-defined obesity, was associated with a more inflammatory pattern of CD16+ monocytes, without monocyte expansion, suggesting that a monocyte maturation process rather than an independent arise of CD16+ monocytes occurs in CO. Thus, in a population with low cardiovascular risk, leptin, VLDL-C, and CD14 expression of CD16+ monocytes predict CO, constituting a putative tool for screening of SIO.

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“…Ряд авторов указывают, что не выявили различий во времени проведения операции, качестве препарата ТМЭ, развитии интраоперационных осложнений, количестве удаленных лимфати-ческих узлов у пациентов с нормальным и по-вышенным ИМТ [13,14]; более того, отмечено что всем пациентам, которым планируется вы-полнение операции по поводу рака средне-и нижнеампулярного отдела прямой кишки, в обязательном порядке необходимо определять индекс висцерального ожирения как наибо-лее чувствительного фактора, оценивающего влияние висцерального жира на выполнение операций по поводу рака прямой кишки [14].…”

Section: Discussionunclassified

Are there any Factors Affecting the Specimen Quality of Total Mesorectumectomy?

Пучков¹,

Хубезов²,

Пучков³

et al. 2017

Novosti Khirurgii

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Российская ФедерацияЦель. Провести анализ результатов выполнения тотальной мезоректумэктомии (ТМЭ) открытым и лапароскопическим доступом, определить факторы, влияющие на качество препарата ТМЭ.Материал и методы. Проведено открытое проспективное рандомизированное исследование, вклю-чившее 193 пациента, которым была выполнена тотальная мезоректумэктомия с выведением петлевой стомы по поводу опухоли средне-и нижнеампулярного отдела прямой кишки. В ходе исследования были проанализированы потенциальные факторы, влияющие на качество ТМЭ: возраст, пол, размеры малого таза, ранее перенесенные оперативные вмешательства на органах брюшной полости и малого таза, про-ведение неоадъювантной лучевой терапии, размеры и локализация опухоли, оперативный доступ, TNM стадия опухолевого процесса.Результаты. Из 193 резекций 117 (60,6%) выполнены лапароскопическим доступом, а 76 (39,4%) -открытым. В ходе операций в 4 случаях (2,07%) выполнена конверсия с лапароскопической к открытой операции. Качество препарата ТМЭ в 132 (68,4%) случаях было оценено как «завершенный», в 56 (29%) -как «почти завершенный» и в 5 (2,6%) -как «незавершенный». «Незавершенные» образцы препаратов были получены при расположении опухоли по передней стенке -3 (60%) случая и по задней -2 (40%) случая. Циркулярная граница резекции (ЦГР) была положительна в 6 (3,1%) препаратах, 5 (2,6%) из которых имели «законченный» вид и 1 (0,51%) -«незаконченный». В одном случае (0,51%) мы получили «незаконченный» препарат при наличии N 1c стадии, а также в 1 (0,51%) случае у пациента со степенью инвазии опухоли T 4b .Заключение. Мужской пол, наличие «трудного» таза, расположение опухоли на передней поверхно-сти прямой кишки и циркулярно потенциально могут повлиять на качество резецированного препарата у пациентов, перенесших ТМЭ по поводу рака прямой кишки. Ключевые слова: рак прямой кишки, тотальная мезоректумэктомия, неоадъювантная лучевая терапия, качество препарата ТМЭ, «завершенная» ТМЭ, лапароскопическая ТМЭObjectives. To analyze the results of performing the total mesorectumectomy (TME) via the an open and laparoscopic access and identification of the factors affecting the quality of TME specimen.Methods. Open prospective randomized trials have been conducted, including patients (n=193) who underwent the total mesorectumectomy with the deriving the loop stoma due to middle-and lower-ampullar rectal cancer. The potential factors affecting TME quality were analyzed: age, sex, pelvic dimensions, previous operations on the abdominal and pelvic organs, neoadjuvant radiation therapy, the size and location of the tumor, a surgical access, TNM stage of the tumor process.Results. Out of 193 resections, 117 (60,6%) have been carried out via laparoscopic access, and 76 (39,4%) -via an open access. Within the operation conversion from laparoscopic to open surgery was made in 4 cases (2,07%). Quality of TME specimen in 132 (68,4%) cases was evaluated as "completed", in 56 (29%) -as "almost completed", and in 5 (2,6%) -as "uncompleted." "Uncompleted" samples of preparations were obta...

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Visceral Obesity and Colorectal Cancer: Are We Missing the Boat with BMI?

Abstract: This study shows that viscerally obese patients with stage II colorectal cancer are at higher risk for poor outcomes and should be increasingly considered for adjuvant chemotherapy.

Cited by 137 publications

References 35 publications

Association between visceral and subcutaneous adiposity and clinicopathological outcomes in non-metastatic clear cell renal cell carcinoma

Association between visceral and subcutaneous adiposity and clinicopathological outcomes in non-metastatic clear cell renal cell carcinoma

Predictors of Subclinical Inflammatory Obesity: Plasma Levels of Leptin, Very Low-Density Lipoprotein Cholesterol and CD14 Expression of CD16+ Monocytes

Are there any Factors Affecting the Specimen Quality of Total Mesorectumectomy?

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