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231
Pathologic Outcomes and Survival in Patients with Rectal Cancer and Increased Body Mass Index
Sameh Hany Emile1,2, Giovanna Dasilva1, Nir Horesh1,3
1Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA.
Digestive Surgery
|August 25, 2024
Summary
Increased body mass index (BMI) did not significantly impact rectal cancer survival or surgical outcomes. Rectal cancer patients with higher BMI showed comparable overall survival and disease-free survival to those with ideal BMI.
Area of Science:
- Oncology
- Clinical Research
- Epidemiology
Background:
- Obesity, indicated by increased body mass index (BMI), is a growing global health concern.
- The relationship between elevated BMI and outcomes in various cancers, including rectal cancer, requires thorough investigation.
Purpose of the Study:
- To evaluate the association between increased body mass index (BMI) and clinicopathologic outcomes, as well as survival rates, in patients with stage I-III rectal adenocarcinoma.
- To determine if BMI at diagnosis influences treatment response and patient prognosis in rectal cancer.
Main Methods:
- A cohort of 243 patients with stage I-III rectal adenocarcinoma who underwent surgery was analyzed.
- Patients were stratified into two groups based on BMI at diagnosis: ideal BMI (18.5-24.9 kg/m2) and increased BMI (≥25 kg/m2).
- Univariate analyses compared baseline characteristics, pathologic outcomes (circumferential resection margin, TNM stage, TME grade), overall survival (OS), and disease-free survival (DFS) between the groups.
Main Results:
- 62.1% of patients had an increased BMI (≥25 kg/m2).
- No significant differences were observed in sex distribution, comorbidities, nodal involvement, or positive circumferential resection margin rates between BMI groups.
- Complete/near-complete total mesorectal incision (TME) rates, pathologic TNM stage, overall survival, and disease-free survival were comparable between patients with ideal and increased BMI, even with a BMI cutoff of 30.
Conclusions:
- Increased BMI in rectal cancer patients did not adversely affect key surgical or survival outcomes.
- While a trend towards more nodal involvement preoperatively and less CRM involvement postoperatively was noted in increased BMI patients, these did not translate to significant differences in survival.
- These findings suggest that elevated BMI may not be a significant prognostic factor for rectal cancer patients undergoing surgery.
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