Is obesity a favorable factor for resectability of rectal cancer?

Background/aims: It is well established that unresectable rectal tumors have a detrimental effect on long-term survival. Predictive factors for resectability focused on the body mass index and surgeon case volume were assessed in the present study.

Methodology: Data of 387 patients with rectal cancer and 284 patients with colon tumor who underwent elective surgical exploration during two periods (1986-1992 and 1994-2001) were evaluated. Univariate and multivariate analysis was performed to estimate the predictive factors for resectability of rectal cancer. The ratio of unresectable rectal and colon tumors was compared in subgroups of patients selected by body mass index.

Results: The observed rate of resectability of rectal cancer was 78%. Coexisted distant metastases, low caseload of surgeons, body mass index < 25 kg/m2, tumor location < or = 12 cm and the first treatment period were associated with low rate of resectability. The ratio of unresectable tumors treated by surgeons with low case volume varied significantly with body mass index in rectal cancers (< 20 = 52%, 20-24.9 = 29%, 25-29.9 = 16%, > or = 30 = 19%) but not in colon tumors.

Conclusions: In respect to resectability of rectal cancer there was significant difference between surgeons with medium and low case volume. Patient's obesity seemed to be a favorable factor for resectability of tumors located in the rectum but not in the colon when operations were performed by surgeons with low case volume.