Visceral obesity determined by CT as a predictor of short-term postoperative complications in patients with ovarian cancer

• Published in: Archives of gynecology and obstetrics Vol. 309; no. 4; pp. 1491 - 1498
• Main Authors: Nie, Xianglin, Zhang, Lin, Meng, Huangyang, Zhong, Yi, Jiang, Yi, Chen, Ting, Cheng, Wenjun
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2024; Springer Nature B.V
• Subjects: Body Mass Index; Carcinoma, Ovarian Epithelial - complications; Carcinoma, Ovarian Epithelial - diagnostic imaging; Endocrinology; Female; Gynecologic Oncology; Gynecology; Human Genetics; Humans; Medicine; Medicine & Public Health; Middle Aged; Obesity; Obesity - complications; Obesity, Abdominal - complications; Obstetrics/Perinatology/Midwifery; Ovarian cancer; Ovarian Neoplasms - complications; Ovarian Neoplasms - diagnostic imaging; Ovarian Neoplasms - surgery; Postoperative Complications - diagnostic imaging; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Risk Factors; Surgery; Tomography, X-Ray Computed; CT; Short-term complications; Cytoreductive surgery; Visceral obesity; Ovarian cancer
• ISSN: 1432-0711; 0932-0067; 1432-0711
• DOI: 10.1007/s00404-023-07206-2

Objective To explore the association between visceral obesity and short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery. Methods The medical records of patients with advanced epithelial ovarian cancer were reviewed. The visceral fat area, subcutaneous fat area and total fat area at the L3/4 level were measured on a preoperative single-slice CT scan. The receiver operating characteristic (ROC) curve was used to calculate the optimal cutoff value for the visceral fat area. The relationship between the visceral fat area and the characteristics of ovarian cancer patients were analyzed. Univariable and multivariable logistic regression analyses were performed to investigate relationship between perioperative characteristics and short-term complications. Results According to the ROC curve, the best cutoff value of the VFA was 93 cm 2 . Of the 130 patients, 53.8% (70/130) had visceral obesity. Patients with visceral obesity were older than those with nonvisceral obesity (58.4 years old vs. 52.1 years old, p  < 0.001). The proportion of patients with hypertension was higher (35.7 vs. 13.3%, p  = 0.003). The total fat area and subcutaneous fat area were larger in patients with visceral obesity (294.3 ± 75.5 vs. 176.2 ± 68.7, p  < 0.001; 158.9 ± 54.7 vs. 121.7 ± 52.6, p  < 0.001). Compared with patients in the nonvisceral obese group, patients in the visceral obese group were more likely to have postoperative fever (21/70 30.0% vs. 8/60 1.25%, p  = 0.023), leading to a longer length of hospital stay (21 days vs. 17 days, p  = 0.009). The time from surgery to adjuvant chemotherapy for patients with visceral obesity was shorter (24 days vs. 19 days, p  = 0.037). Multivariate analysis showed that visceral obesity (OR = 6.451, p  < 0.001) and operation time (OR = 1.006, p  < 0.001) were independent predictors of postoperative complications. Conclusion Visceral obesity is an important risk factor for short-term postoperative complications in patients with advanced ovarian cancer undergoing cytoreductive surgery.