Patients Obese and overweight with locally advanced rectal cancer are as likely to respond to neoadjuvant chemoradiotherapy (nCRT) as normal weight patients. To say it is a study by the University of Padua that found no association between body mass index (BMI) or body fat composition and survival. However, excess weight affects the complications of therapy.
Some studies have suggested that visceral fat plays a role in the mechanisms on which sensitivity to chemotherapy depends.To explore the relationship between obesity and response to therapy in rectal cancer, the study authors examined all patients who underwent surgical resection after nCRT between 2005 and 2017. Using CT scans, for each patient they calculated several radiological parameters related to body fat composition, including visceral fat area (VFA), surface fat area (SFA), and visceral to surface fat ratio (V/S) at baseline. Using logistic regression analysis they then assessed the correlation between BMI and visceral fat and survival.
Of the 144 patients included in the analysis, 32 (22%) achieved a pathologic complete response and 60 (45.5%) a major pathological response. With a median follow-up of 60 months, there were no differences in overall survival and disease-free survival stratifying patients by BMI or radiological parameters. BMI and radiological parameters were not predictive factors of complete or major pathological response.In contrast, elevated VFA, V/S and BMI values predicted patients at risk of major postoperative complications.
«In our study, general obesity and visceral fat do not correlate with the pathological response, so these parameters should not be considered contraindications for the organ preservation approach – write the authors in the article published in the journal Frontiers in Oncology, underlining that – This is the first study to analyze the relationship between obesity and oncological outcomes in a group of Italian rectal cancer patients, while most of the studies come from the USA or China where the estimated obesity rate is higher, respectively 36% and 16% [in Italy it is 10%]».
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Source — https://www.univadis.it/viewarticle/grasso-viscerale-e-risposta-alla-terapia-non-2022a10025hl