Impact of body mass index as a continuous variable on short‐ and long‐term outcomes in patients undergoing laparoscopic surgery for colon cancer

Abstract Background The impact of obesity on colon cancer remains unclear. Very few studies of colon cancer surgery have analyzed body mass index (BMI) as a continuous variable, with no such reports from Japan. This study examined the association between BMI as a continuous variable and short‐ and l...

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Main Authors: Takayuki Aiba, Tomonori Akagi, Hidefumi Shiroshita, Kentaro Nakajima, Tetsuji Ohyama, Tatsuya Kinjo, Akiyoshi Kanazawa, Nobuaki Suzuki, Takuya Tokunaga, Manabu Yamamoto, Nobuki Ichikawa, Shungo Endo, Yutaka Kojima, Takatoshi Nakamura, Shuji Saito, Yoshinori Kagawa, Shinobu Ohnuma, Seiichiro Yamamoto, Takeshi Naitoh, Masafumi Inomata
Format: Article
Language:English
Published: Wiley 2025-05-01
Series:Annals of Gastroenterological Surgery
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Online Access:https://doi.org/10.1002/ags3.12916
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author Takayuki Aiba
Tomonori Akagi
Hidefumi Shiroshita
Kentaro Nakajima
Tetsuji Ohyama
Tatsuya Kinjo
Akiyoshi Kanazawa
Nobuaki Suzuki
Takuya Tokunaga
Manabu Yamamoto
Nobuki Ichikawa
Shungo Endo
Yutaka Kojima
Takatoshi Nakamura
Shuji Saito
Yoshinori Kagawa
Shinobu Ohnuma
Seiichiro Yamamoto
Takeshi Naitoh
Masafumi Inomata
author_facet Takayuki Aiba
Tomonori Akagi
Hidefumi Shiroshita
Kentaro Nakajima
Tetsuji Ohyama
Tatsuya Kinjo
Akiyoshi Kanazawa
Nobuaki Suzuki
Takuya Tokunaga
Manabu Yamamoto
Nobuki Ichikawa
Shungo Endo
Yutaka Kojima
Takatoshi Nakamura
Shuji Saito
Yoshinori Kagawa
Shinobu Ohnuma
Seiichiro Yamamoto
Takeshi Naitoh
Masafumi Inomata
author_sort Takayuki Aiba
collection DOAJ
description Abstract Background The impact of obesity on colon cancer remains unclear. Very few studies of colon cancer surgery have analyzed body mass index (BMI) as a continuous variable, with no such reports from Japan. This study examined the association between BMI as a continuous variable and short‐ and long‐term outcomes of laparoscopic surgery for obese colon cancer patients. Methods Obese (BMI ≥25 kg/m2) patients who underwent laparoscopic radical surgery for Stage II/III colon cancer at 46 participating centers from 2009 to 2013 were included. Associations between short‐ and long‐term outcomes and BMI as a continuous variable were analyzed by univariate and multivariate regression models. Results Among patients meeting the study criteria, 1036 were examined. BMI as a continuous variable correlated with log‐transformed operative time (regression coefficient: 0.02, 95% confidence interval [CI]: 0.012–0.028, p < 0.05) and blood loss (odds ratio: 1.089, 95% CI: 1.032–1.149, p < 0.05). There was no association between BMI continuous variables and 3‐year relapse‐free survival (RFS) and overall survival. However, 3‐year RFS was possibly better in patients with BMI ≥28.5 kg/m2 versus those with BMI <28.5 kg/m2 (hazard ratio: 0.682, 95% CI: 0.462–1.008, p = 0.055). Conclusions This study showed that BMI as a continuous variable correlated with operative time and blood loss. RFS was possibly better in the severely obese patients (BMI ≥28.5 kg/m2), suggesting that the prognosis for highly obese colon cancer patients appears to follow the obesity paradox.
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spelling doaj-art-8b94e1c4b3de4ec2b4530973b18d73042025-08-20T03:49:40ZengWileyAnnals of Gastroenterological Surgery2475-03282025-05-019339240010.1002/ags3.12916Impact of body mass index as a continuous variable on short‐ and long‐term outcomes in patients undergoing laparoscopic surgery for colon cancerTakayuki Aiba0Tomonori Akagi1Hidefumi Shiroshita2Kentaro Nakajima3Tetsuji Ohyama4Tatsuya Kinjo5Akiyoshi Kanazawa6Nobuaki Suzuki7Takuya Tokunaga8Manabu Yamamoto9Nobuki Ichikawa10Shungo Endo11Yutaka Kojima12Takatoshi Nakamura13Shuji Saito14Yoshinori Kagawa15Shinobu Ohnuma16Seiichiro Yamamoto17Takeshi Naitoh18Masafumi Inomata19Department of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Yufu JapanDepartment of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Yufu JapanDepartment of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Yufu JapanDepartment of Surgery NTT Medical Center Tokyo Shinagawa‐ku JapanBiostatistics Center Kurume University Fukuoka JapanDepartment of Digestive and General Surgery University of the Ryukyus Hospital Nishihara JapanDepartment of Surgery Shimane Prefectural Central Hospital Izumo JapanDepartment of Gastroenterological, Breast and Endocrine Surgery Yamaguchi University Graduate School of Medicine Ube JapanDepartment of Digestive and Transplant Surgery Tokushima University Hospital Tokushima JapanDivision of Gastrointestinal and Pediatric Surgery, Department of Surgery Tottori University Faculty of Medicine Yonago JapanDepartment of Gastroenterological Surgery I Graduate School of Medicine, Hokkaido University Sapporo JapanDepartment of Coloproctology Aizu Medical Center Fukushima Medical University Fukushima JapanDepartment of Coloproctological Surgery Juntendo University Faculty of Medicine Bunkyo‐ku JapanDepartment of Colorectal Surgery Dokkyo Medical University Shimotsuga‐gun JapanDivision of Surgery, Gastrointestinal Center Yokohama Shin‐Midori General Hospital Yokohama JapanDepartment of Gastroenterological Surgery Osaka International Cancer Institute Osaka JapanDepartment of Surgery Tohoku University Graduate School of Medicine Sendai JapanDepartment of Gastroenterological Surgery Tokai University School of Medicine Shibuya JapanDepartment of Lower Gastrointestinal Surgery Kitasato University School of Medicine Sagamihara JapanDepartment of Gastroenterological and Pediatric Surgery Oita University Faculty of Medicine Yufu JapanAbstract Background The impact of obesity on colon cancer remains unclear. Very few studies of colon cancer surgery have analyzed body mass index (BMI) as a continuous variable, with no such reports from Japan. This study examined the association between BMI as a continuous variable and short‐ and long‐term outcomes of laparoscopic surgery for obese colon cancer patients. Methods Obese (BMI ≥25 kg/m2) patients who underwent laparoscopic radical surgery for Stage II/III colon cancer at 46 participating centers from 2009 to 2013 were included. Associations between short‐ and long‐term outcomes and BMI as a continuous variable were analyzed by univariate and multivariate regression models. Results Among patients meeting the study criteria, 1036 were examined. BMI as a continuous variable correlated with log‐transformed operative time (regression coefficient: 0.02, 95% confidence interval [CI]: 0.012–0.028, p < 0.05) and blood loss (odds ratio: 1.089, 95% CI: 1.032–1.149, p < 0.05). There was no association between BMI continuous variables and 3‐year relapse‐free survival (RFS) and overall survival. However, 3‐year RFS was possibly better in patients with BMI ≥28.5 kg/m2 versus those with BMI <28.5 kg/m2 (hazard ratio: 0.682, 95% CI: 0.462–1.008, p = 0.055). Conclusions This study showed that BMI as a continuous variable correlated with operative time and blood loss. RFS was possibly better in the severely obese patients (BMI ≥28.5 kg/m2), suggesting that the prognosis for highly obese colon cancer patients appears to follow the obesity paradox.https://doi.org/10.1002/ags3.12916body mass indexcolon cancercontinuous variablelaparoscopic surgeryobesity paradox
spellingShingle Takayuki Aiba
Tomonori Akagi
Hidefumi Shiroshita
Kentaro Nakajima
Tetsuji Ohyama
Tatsuya Kinjo
Akiyoshi Kanazawa
Nobuaki Suzuki
Takuya Tokunaga
Manabu Yamamoto
Nobuki Ichikawa
Shungo Endo
Yutaka Kojima
Takatoshi Nakamura
Shuji Saito
Yoshinori Kagawa
Shinobu Ohnuma
Seiichiro Yamamoto
Takeshi Naitoh
Masafumi Inomata
Impact of body mass index as a continuous variable on short‐ and long‐term outcomes in patients undergoing laparoscopic surgery for colon cancer
Annals of Gastroenterological Surgery
body mass index
colon cancer
continuous variable
laparoscopic surgery
obesity paradox
title Impact of body mass index as a continuous variable on short‐ and long‐term outcomes in patients undergoing laparoscopic surgery for colon cancer
title_full Impact of body mass index as a continuous variable on short‐ and long‐term outcomes in patients undergoing laparoscopic surgery for colon cancer
title_fullStr Impact of body mass index as a continuous variable on short‐ and long‐term outcomes in patients undergoing laparoscopic surgery for colon cancer
title_full_unstemmed Impact of body mass index as a continuous variable on short‐ and long‐term outcomes in patients undergoing laparoscopic surgery for colon cancer
title_short Impact of body mass index as a continuous variable on short‐ and long‐term outcomes in patients undergoing laparoscopic surgery for colon cancer
title_sort impact of body mass index as a continuous variable on short and long term outcomes in patients undergoing laparoscopic surgery for colon cancer
topic body mass index
colon cancer
continuous variable
laparoscopic surgery
obesity paradox
url https://doi.org/10.1002/ags3.12916
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