TY - JOUR
T1 - Low Visceral Fat Content is Associated with Poor Prognosis in a Database of 507 Upper Gastrointestinal Cancers
AU - Harada, Kazuto
AU - Baba, Yoshifumi
AU - Ishimoto, Takatsugu
AU - Kosumi, Keisuke
AU - Tokunaga, Ryuma
AU - Izumi, Daisuke
AU - Ida, Satoshi
AU - Imamura, Yu
AU - Iwagami, Shiro
AU - Miyamoto, Yuji
AU - Sakamoto, Yasuo
AU - Yoshida, Naoya
AU - Watanabe, Masayuki
AU - Baba, Hideo
N1 - Publisher Copyright:
© 2015, Society of Surgical Oncology.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Background: Excess visceral adipose tissue may promote cancer development and progression via an obesity-related metabolic derangements, including adipocytokine-related inflammation, insulin resistance, and hypoxia. The relationship between visceral fat content and patient prognosis has been reported in some types of cancers, but not in the upper gastrointestinal cancer. The purpose of this retrospective study was to investigate the relationship between visceral fat status and clinical outcome in patients with upper gastrointestinal cancers (esophageal cancer and gastric cancer) treated by surgical resection. Methods: This retrospective study was conducted in a single, academic hospital in Kumamoto, Japan, and involved 507 patients with upper gastrointestinal cancers between April 2005 and December 2010. Preoperative visceral fat content was quantified by radiologic measures using standard computed tomography scans. Results: Higher visceral fat mount was correlated with male sex, presence of preoperative comorbidity, absence of preoperative therapy, low tumor depth, low tumor stage, and gastric cancer. Compared to high visceral fat cases, low visceral fat cases experienced a higher overall mortality rate [log-rank p = 0.0050; univariate hazard ratio (HR) = 1.73, 95 % confidence interval (CI) 1.16–2.54; p = 0.0075; multivariate HR 1.57; 95 % CI 1.02–2.37; p = 0.031]. Interestingly, the influence of low visceral fat on patient outcome was modified by age at surgery (p for interaction = 0.036); low visceral fat was associated with a poor prognosis, especially in elderly patients (log-rank p < 0.0001). Conclusion: Visceral fat content in the upper gastrointestinal cancers was associated with a poor prognosis, thus suggesting that it has potential for use as a prognostic biomarker.
AB - Background: Excess visceral adipose tissue may promote cancer development and progression via an obesity-related metabolic derangements, including adipocytokine-related inflammation, insulin resistance, and hypoxia. The relationship between visceral fat content and patient prognosis has been reported in some types of cancers, but not in the upper gastrointestinal cancer. The purpose of this retrospective study was to investigate the relationship between visceral fat status and clinical outcome in patients with upper gastrointestinal cancers (esophageal cancer and gastric cancer) treated by surgical resection. Methods: This retrospective study was conducted in a single, academic hospital in Kumamoto, Japan, and involved 507 patients with upper gastrointestinal cancers between April 2005 and December 2010. Preoperative visceral fat content was quantified by radiologic measures using standard computed tomography scans. Results: Higher visceral fat mount was correlated with male sex, presence of preoperative comorbidity, absence of preoperative therapy, low tumor depth, low tumor stage, and gastric cancer. Compared to high visceral fat cases, low visceral fat cases experienced a higher overall mortality rate [log-rank p = 0.0050; univariate hazard ratio (HR) = 1.73, 95 % confidence interval (CI) 1.16–2.54; p = 0.0075; multivariate HR 1.57; 95 % CI 1.02–2.37; p = 0.031]. Interestingly, the influence of low visceral fat on patient outcome was modified by age at surgery (p for interaction = 0.036); low visceral fat was associated with a poor prognosis, especially in elderly patients (log-rank p < 0.0001). Conclusion: Visceral fat content in the upper gastrointestinal cancers was associated with a poor prognosis, thus suggesting that it has potential for use as a prognostic biomarker.
UR - http://www.scopus.com/inward/record.url?scp=84943361620&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84943361620&partnerID=8YFLogxK
U2 - 10.1245/s10434-015-4432-4
DO - 10.1245/s10434-015-4432-4
M3 - Article
C2 - 25712800
AN - SCOPUS:84943361620
SN - 1068-9265
VL - 22
SP - 3946
EP - 3953
JO - Annals of surgical oncology
JF - Annals of surgical oncology
IS - 12
ER -