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Prognostic implications of visceral obesity on gastric adenocarcinoma: does it really matter?

      Highlights

      • Visceral obesity may not have an impact on prognosis in resectable gastric-adenocarcinoma.
      • The significant factors for overall survival were tumor grade, T-stage and N-stage.
      • Body fat composition is not associated with N-stage.

      Abstract

      Purpose

      To evaluate the association of visceral adiposity measured on computed tomography (CT) in preoperative period with lymph node (LN) metastasis and overall survival in gastric adenocarcinoma patients.

      Methods

      Preoperative CT scans of 246 gastric adenocarcinoma patients who did not receive neoadjuvant chemoradiotherapy were evaluated. Visceral fat area (VFA), subcutaneous fat area (SFA) and Total fat area (TFA), VFA/TFA ratio were quantified by CT. VFA/TFA > 29% was defined as visceral obesity. The differentiation, t-stage, n-stage and the number of harvested-metastatic LNs were noted. The maximum thickness of tumor and localization were recorded from CT. Chi-square, Student's t-test, multiple Cox regression, Spearman's correlation coefficient, and Kaplan-Meier algorithm were performed.

      Results

      The overall survival (OS) rates and N-stage were not different significantly between viscerally obese and non-obese group (p = 0.994, p = 0.325). The number of metastatic LNs were weakly inversely correlated with VFA (r = −0.144, p = 0.024). Univariate analysis revealed no significant association between visceral obesity and OS or LN metastasis (p = 0.377, p = 0.736). In multivariate analyses, OS was significantly associated with poorly differentiation (HR = 1.72, 95% CI =1.04–2.84, p = 0.035), higher pathologic T and N stage (T4 vs T1 + T2 HR = 2.67, 95% CI =1.18–6.04, p = 0.019; T3 vs T1 + T2 HR = 1.98, 95% CI = 0.90–4.33, p = 0.089; N3b vs N0 HR = 2.97, 95% CI1.45–6.0, p = 0.003; N3 (3a+ 3b) vs N0 HR = 2.24 95% CI =1.15–4.36, p = 0.018).

      Conclusion

      Visceral obesity may not be a prognostic factor in resectable gastric adenocarcinoma patients.

      Keywords

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