Visceral obesity determined by CT as a predictor of short-term postoperative complications in ovarian cancer

Abstract

Objective: To explore the association between visceral obesity and short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery. Methods: Medical records were reviewed for patients with advanced epithelial ovarian cancer. Visceral fat area, subcutaneous fat area and total fat area were measured on a single slice at the level of L3/4 of a preoperative CT scan. The Receiver Operating Characteristic (ROC) curve was used to calculate the optimal cut-off value for visceral fat area. Relationships between visceral fat area and characteristics of ovarian cancer patients were analyzed. Univariable and multivariable Logistic regression analyseswere performed to investigate the value of perioperative characteristics of patients on short-term complications. Results: According to the ROC curve, the best cut-off value of VFA was 93 cm². Of the 130 patients, 53.8% (70/130) were presented visceral obesity. Patients with visceral obesity were older than those with non-visceral obesity (58.4 years old vs. 52.1 years old, p < 0.001). The proportion of patients with hypertension was higher (35.7% vs. 13.3%, p = 0.003). The total fat area and subcutaneous fat area were higher in patients with visceral obesity (294.3 ± 75.5 vs. 176.2 ± 68.7, p < 0.001; 158.9 ± 54.7 vs. 121.7 ± 52.6, p < 0.001). Compared with patients in the non-visceral obese group, patients in the visceral obese group were more likely to have postoperative fever (21/70 30.0% vs. 8/60 1.25%, p = 0.023), leading to a longer length of hospital stay (21 days vs. 17 days, p = 0.009). Time from surgery to adjuvant chemotherapy for patients with visceral obesity has been delayed (24 days vs. 19 days, p = 0.037). Multivariate analysis showed that visceral obesity (OR = 6.451, p < 0.001) and operation time (OR = 1.006, p < 0.001) were independent predictors of postoperative complications. Conclusion: Visceral obesity is an important risk factor for short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery.