PMID- 29937416
OWN - NLM
STAT- MEDLINE
DCOM- 20181219
LR  - 20181219
IS  - 1532-2157 (Electronic)
IS  - 0748-7983 (Linking)
VI  - 44
IP  - 12
DP  - 2018 Dec
TI  - Obesity as a determinant of perioperative and postoperative outcome in patients
      following colorectal cancer surgery: A population-based study (2009-2016).
PG  - 1849-1857
LID - S0748-7983(18)31104-1 [pii]
LID - 10.1016/j.ejso.2018.05.027 [doi]
AB  - BACKGROUND: Obesity is an increasing problem worldwide that can influence
      perioperative and postoperative outcomes. However, the relationship between
      obesity and treatment-related perioperative and short-term postoperative
      morbidity after colorectal resections is still subject to debate. STUDY: Patients
      were selected from the DCRA, a population-based audit including 83 hospitals
      performing colorectal cancer (CRC) surgery. Data regarding primary resections
      between 2009 and 2016 were eligible for analyses. Patients were subdivided into
      six categories: underweight, normal weight, overweight and obesity class I, II
      and III. RESULTS: Of 71,084 patients, 17.7% with colon and 16.4% with rectal
      cancer were categorized as obese. Significant differences were found for the
      30-day overall postoperative complication rate (p < 0.001), prolonged
      hospitalization (p < 0.001) and readmission rate (colon cancer p < 0.005; rectal 
      cancer p < 0.002) in obese CRC patients. Multivariate analysis identified BMI
      >/=30 kg/m(2) as independent predictor of a complicated postoperative course in
      CRC patients. Furthermore, obesity-related comorbidities were associated with
      higher postoperative morbidity, prolonged hospitalization and a higher
      readmission rate. No significant differences in performance were observed in
      postoperative outcomes of morbidly obese CRC patients between hospitals
      performing bariatric surgery and hospitals that did not. CONCLUSION: The
      real-life data analysed in this study reflect daily practice in the Netherlands
      and identify obesity as a significant risk factor in CRC patients.
      Obesity-related comorbidities were associated with higher postoperative
      morbidity, prolonged hospitalization and a higher readmission rate in obese CRC
      patients. No differences were observed between hospitals performing bariatric
      surgery and hospitals that did not.
CI  - Copyright (c) 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and
      the European Society of Surgical Oncology. All rights reserved.
FAU - Poelemeijer, Youri Q M
AU  - Poelemeijer YQM
AD  - Department of Surgery, Leiden University Medical Center, Leiden, Netherlands;
      Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, Netherlands.
      Electronic address: y.q.m.poelemeijer@lumc.nl.
FAU - Lijftogt, Niki
AU  - Lijftogt N
AD  - Department of Surgery, Leiden University Medical Center, Leiden, Netherlands.
FAU - Detering, Robin
AU  - Detering R
AD  - Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, Netherlands;
      Department of Surgery, Academic Medical Center, Amsterdam, Netherlands.
FAU - Fiocco, Marta
AU  - Fiocco M
AD  - Medical Statistics and Bioinformatics Department, Leiden University Medical
      Center, Leiden, Netherlands.
FAU - Tollenaar, Rob A E M
AU  - Tollenaar RAEM
AD  - Department of Surgery, Leiden University Medical Center, Leiden, Netherlands;
      Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, Netherlands.
FAU - Wouters, Michel W J M
AU  - Wouters MWJM
AD  - Scientific Bureau, Dutch Institute for Clinical Auditing, Leiden, Netherlands;
      Department of Surgical Oncology, Netherlands Cancer Institute-Antoni van
      Leeuwenhoek Hospital, Amsterdam, Netherlands.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20180606
PL  - England
TA  - Eur J Surg Oncol
JT  - European journal of surgical oncology : the journal of the European Society of
      Surgical Oncology and the British Association of Surgical Oncology
JID - 8504356
SB  - IM
CIN - Eur J Surg Oncol. 2018 Dec;44(12):1997. PMID: 30217354
CIN - Eur J Surg Oncol. 2018 Dec;44(12):1998. PMID: 30217353
MH  - Aged
MH  - Aged, 80 and over
MH  - Colorectal Neoplasms/*surgery
MH  - Female
MH  - Humans
MH  - Intraoperative Complications/*epidemiology
MH  - Length of Stay/statistics & numerical data
MH  - Male
MH  - Middle Aged
MH  - Netherlands/epidemiology
MH  - Obesity/*complications
MH  - Patient Readmission/statistics & numerical data
MH  - Postoperative Complications/epidemiology
MH  - Risk Factors
MH  - Treatment Outcome
OTO - NOTNLM
OT  - *Colorectal cancer
OT  - *Complications
OT  - *Dutch ColoRectal audit
OT  - *Obesity
OT  - *Outcome
OT  - *Population-based
EDAT- 2018/06/26 06:00
MHDA- 2018/12/20 06:00
CRDT- 2018/06/26 06:00
PHST- 2017/12/08 00:00 [received]
PHST- 2018/04/24 00:00 [revised]
PHST- 2018/05/23 00:00 [accepted]
PHST- 2018/06/26 06:00 [pubmed]
PHST- 2018/12/20 06:00 [medline]
PHST- 2018/06/26 06:00 [entrez]
AID - S0748-7983(18)31104-1 [pii]
AID - 10.1016/j.ejso.2018.05.027 [doi]
PST - ppublish
SO  - Eur J Surg Oncol. 2018 Dec;44(12):1849-1857. doi: 10.1016/j.ejso.2018.05.027.
      Epub 2018 Jun 6.