Özet:

Aim: To evaluate the effect of body mass index (BMI) on the short- and long-term oncological outcomes and postoperative complications of patients with rectal cancer who underwent total mesorectal excision (TME) following neoadjuvant chemoradiotherapy (NACRT). Obesity is a known risk factor for colorectal cancer. Patients classified as obese are more likely to have increased morbidity and prolonged hospitalization; this is particularly relevant in Jordan-a country ranked high in the worldwide obesity index. Method: A retrospective cohort of 294 patients with locally advanced rectal cancer (stage 2 T3/4 node negative or stage 3 node positive) who underwent TME after NACRT between 2006 and 2018 was divided into two groups (obese: ≥30 kg/m2 and non-obese: <30 kg/m2) according to BMI. Clinicopathological comparisons between the groups were performed in addition to a survival analysis, which was plotted on a Kaplan-Meier curve. The main outcomes were disease-free survival (DFS) and overall survival (OS), and the secondary outcomes were complete pathological response (pCR) and post-operative complications. Results: There were 140 and 154 patients in the non-obese and obese groups, respectively. The mean age of the entire cohort was 54.2 years, the mean BMI was 28.4 kg (+/– 6.1), and the median time interval between NACRT and surgery was 10.3 weeks (interquartile range: 8.4, 13.4). The mean follow-up period was 42 months. Both groups had similar baseline clinicopathological characteristics. Patients with obesity were more likely to achieve a pCR (p=0.034) and have a higher percentage of positive lymph nodes in their resected specimens (p=0.05). Patients with obesity also had a higher risk of developing incisional herniation but not other complications (p=0.018). OS was comparable between the groups, while DFS was higher in patients with obesity. Conclusion: In our local cohort of patients, obesity affected incisional hernia formation. It did not have an impact on OS; however, the patients in the obese group had higher DFS and pCR rates than those in the non-obese group.

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