Malnutrition and visceral obesity predict adverse short-term and long-term outcomes in patients undergoing proctectomy for rectal cancer

Abstract Background There was no study explored the relationship of malnutrition and visceral obesity in rectal cancer patients following radical proctectomy. Therefore, we aimed to investigate the value of malnutrition and visceral obesity in patients with rectal cancer. Methods This study included patients with rectal cancer who underwent proctectomy. Malnutrition was defined by Global Leadership Initiative on Malnutrition (GLIM). Visceral obesity was measured by computed tomography (CT). Patients were classified into four groups according to the presence of malnutrition or visceral obesity. Univariate and multivariate logistic regression analyses were performed to evaluate the risk factors for postoperative complications. Univariate and multivariate cox regression analyses were performed to evaluate the risk factors for overall survival (OS). Kaplan-Meier survival curves and log-rank tests were performed by four groups in patients with rectal cancer. Results This study enrolled 624 patients. 204 (32.7%) patients in the well-nourished non-visceral obesity (WN) group, 264 (42.3%) patients in the well-nourished visceral obesity (WO) group, 114 (18.3%) patients in the malnourished non-visceral obesity (MN) group, and 42 (6.7%) patients in the malnourished visceral obesity (MO) group. In the multivariate cox regression analysis, Charlson comorbidity index (CCI), MN and MO were associated with postoperative complications. In the multivariate cox regression analysis, age, American Society of Anesthesiologists (ASA), tumor differentiation, tumor node metastasis (TNM), and MO were associated with worse OS. Conclusion This study demonstrated that the MO group had the higher postoperative complication and mortality rate and was a good indicator of poor prognosis in patients with rectal cancer.