Obesity is a risk factor for multifocal disease and recurrence after colorectal cancer surgery: A case-control study

Marco Scarpa, Cesare Ruffolo, Francesca Erroi, Alain Fiorot, Silvia Basato, Anna Pozza, Fabio Canal, Marco Massani, Francesco Cavallin, Michele Antoniutti, Nicolò Bassi, Carlo Castoro

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Abstract

Background: Several studies have demonstrated that obesity is a risk factor for colorectal cancer (CRC), but few data are available regarding its role in multifocal disease and postoperative recurrence. The present study aimed to assess the role of obesity as a risk factor for multifocal disease and postoperative recurrence in patients with CRC. Patients and Methods: The records of 940 consecutive patients with CRC admitted to three surgical centres between January 2006 and January 2011 were retrospectively analysed. The 595 individuals whose preoperative body mass index (BMI) values were available were included in the study. Following WHO guidelines, the patients were stratified into four groups depending on their BMI values. Age at disease onset, clinical presentation, tumor invasiveness, the presence of multiple foci, and the colon cancer recurrence rate in the four groups were assessed and compared. Results: At multivariate analysis, diagnosis of familial adenomatous polyposis (FAP) and a BMI>30 were found to be independent predictors of synchronous polyps (Odd Ratio [OR]=10.7, 95% Confidence interval (CI)=2-75, p=0.005; and OR=2.2, 95% CI=1.3-3.9, p=0.003, respectively). The cancer recurrence rate in the patients with stage 2 CRC was significantly higher in the obese with respect to the non-obese (p=0.05). At multivariate analysis, BMI>30, FAP, and positivity by the Bethesda criteria were found to be independent predictors of recurrence after CRC surgery. Conclusion: Obese patients diagnosed with CRC require thorough colonic exploration prior to surgery and necessitate more frequent postoperative endoscopic examinations with respect to patients without any risk factors.

Original languageEnglish
Pages (from-to)5735-5741
Number of pages7
JournalAnticancer Research
Volume34
Issue number10
Publication statusPublished - Oct 1 2014

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Keywords

  • Adenoma
  • Bethesda criteria
  • Colorectal cancer
  • Obesity

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Scarpa, M., Ruffolo, C., Erroi, F., Fiorot, A., Basato, S., Pozza, A., Canal, F., Massani, M., Cavallin, F., Antoniutti, M., Bassi, N., & Castoro, C. (2014). Obesity is a risk factor for multifocal disease and recurrence after colorectal cancer surgery: A case-control study. Anticancer Research, 34(10), 5735-5741.