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Is visceral obesity associated with colorectal cancer? The first volumetric study using all CT slices.

PURPOSE
To examine the possible relationship between abdominal adiposity parameters and the presence of colorectal cancer (CRC) and between these adiposity parameters and various histopathological findings of the tumor.


METHODS
A total of 60 control subjects and 111 patients with colorectal cancer (CRC), 63 with early-stage and 48 with advanced-stage disease, were enrolled. Medical data and abdominopelvic CT examinations of each study group were retrospectively reviewed. Abdominal adiposity parameters, including visceral adipose tissue (VAT) volume, subcutaneous adipose tissue (SAT) volume, and total adipose tissue (TAT) volume, were calculated on all slices of the CT examinations with specialized software, and results for each study group were compared. Adiposity parameters were also compared with tumor histopathologic findings.


RESULTS
We found lower VAT and higher SAT volumes in advanced-stage CRC patients, compared to the early-stage group. However, this relationship was not statistically significant (P = 0.721 for VAT and P = 0.432 for SAT volumes). We detected significantly lower VAT and SAT volumes in the early-stage CRC group, when compared with the control group (P = 0.014 for both). There was no significant relationship between TAT volumes and the study groups (P = 0.06). No statistically significant relationship was detected between adipose tissue parameters and histopathological features of the CRC group (P > 0.05).


CONCLUSION
We found statistically significant lower VAT and SAT volumes in patients with early-stage CRC compared to the control group. Volumetric adipose tissue measurements may be more accurate than area measurements and can easily be performed on abdominopelvic CT examination, which is the routine imaging modality for CRC patients.