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Clinical Impact of Abdominal Fat Distribution on Prognosis After Esophagectomy for Esophageal Squamous Cell Carcinoma

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Excessive visceral fat may promote cancer development and progression because of metabolic derangements. The purpose of this study was to clarify the impact of abdominal fat distribution on patient prognosis after esophagectomy for esophageal squamous cell carcinoma (ESCC).

Methods

Computed tomography volumetry was performed in 150 patients who underwent curative esophagectomy for ESCC between 2012 and 2013. Visceral fat area (VFA) and subcutaneous fat area (SFA) at umbilicus level were measured, and the VFA/SFA ratio was calculated in each patient. Prognoses of the patients were compared between groups classified according to VFA/SFA ratio.

Results

Both relapse-free survival and overall survival of the low VFA/SFA group were significantly better than those of the high VFA/SFA group (log-rank test p = 0.005, p = 0.01). Univariate analysis also found that low VFA/SFA ratio significantly predicted an increase in relapse-free and overall survival. In multivariate analysis, low VFA/SFA ratio was an independent factor for relapse-free survival [p = 0.042, hazard ratio (HR) 0.12, 95 % confidence interval (CI) 0.01–0.93]. In addition, low VFA/SFA ratio tended to be a significant variable that predicted better overall survival (p = 0.057, HR 0.14, 95 % CI 0.01–1.05).

Conclusions

Low VFA/SFA ratio was significantly associated with better prognosis in patients who undergo curative esophagectomy for ESCC. Abdominal fat distribution may influence the biological features of ESCC.

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Acknowledgments

This work was supported in part by the Japan Society for the Promotion of Science (JSPS) Grant-in-Aid for Scientific Research (Grant number 15K10122).

Disclosure

There are no financial or other relations that could lead to a conflict of interest.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan

    Akihiko Okamura MD, Masayuki Watanabe MD, Shinji Mine MD, Koujiro Nishida MD, Yu Imamura MD, Takanori Kurogochi MD & Takeshi Sano MD

  2. Department of Surgery, School of Medicine, Keio University, Tokyo, Japan

    Yuko Kitagawa MD

Authors
  1. Akihiko Okamura MD
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  2. Masayuki Watanabe MD
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  3. Shinji Mine MD
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  4. Koujiro Nishida MD
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  5. Yu Imamura MD
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  6. Takanori Kurogochi MD
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  7. Yuko Kitagawa MD
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  8. Takeshi Sano MD
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Correspondence to Masayuki Watanabe MD.

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Okamura, A., Watanabe, M., Mine, S. et al. Clinical Impact of Abdominal Fat Distribution on Prognosis After Esophagectomy for Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 23, 1387–1394 (2016). https://doi.org/10.1245/s10434-015-5018-x

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  • DOI: https://doi.org/10.1245/s10434-015-5018-x

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