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Objective
Obesity (BMI>30) is reported to worsen outcomes after colon cancer surgery. Most research, however, has been performed outside of specialized bariatric centers. We sought to determine if colon cancer outcomes are affected by obesity in a bariatric center.
Design
A retrospective review of a prospectively managed patient database.
Setting
Tertiary academic center.
Patients
137 consecutive patients undergoing elective colectomy for adenocarcinoma at a single institution from 2008-2009.
Main outcome measures
Major and minor post-operative complications, tumor characteristics, lymph node harvest as well as operating times and hospital length of stay were measured.
Results
While major complications were similar (2% vs 6% p=0.424), minor complications occurred less frequently in obese patients (37% vs 6% p=0.014). Operating times (143mins vs 151mins, p=0.741) and average length of stay (4.8 vs 5 days, p=0.766) were similar between both groups of patients. For all tumor stages, patients with a BMI>30 had similar tumor characteristics such as high grade differentiation (20% vs 18.9%, p=0.905), presence of neural invasion (14.8% vs 28.6%, p=0.147) and vascular invasion (33.3% vs 39.4%, p=0.565). The mean number of lymph nodes harvested (23 vs 20, p=0.741) and the number of positive lymph nodes within resected specimens (6 vs 5, p=0.261) were similar. On logistic regression, BMI>30 was an independent predictor of fewer minor complications (p=0.037, OR=0.1).
Conclusions
In a hospital that has a bariatric surgical program, obese patients with colon cancer have a similar tumor profile but fewer minor post-operative complications, and the same number of major complications as non-obese patients.