Impact of visceral obesity on postoperative complications and oncological outcomes in elderly patients with colorectal cancer

doi:10.4251/wjgo.v18.i1.109735

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World Journal of Gastrointestinal Oncology

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1948-5204

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastrointest Oncol. Jan 15, 2026; 18(1): 109735
Published online Jan 15, 2026. doi: 10.4251/wjgo.v18.i1.109735

Table 1 Comparison of general data between the two groups, n (%)

Factor	Abdominal obesity group (n = 80)	Non-abdominal obesity group (n = 70)	χ²/t	P value
Age (years)	72.63 ± 5.32	71.91 ± 5.58	0.788	0.432
Male	52 (65.00)	45 (64.29)	0.005	0.943
Tumor site
Carcinoma of colon	45 (56.25)	38 (54.29)	0.057	0.811
Rectal cancer	35 (43.75)	32 (45.71)
TNM stage I-II	34 (42.50)	29 (41.43)	0.018	0.893
TNM stage III	46 (57.50)	41 (58.57)
Combined hypertension	38 (47.50)	32 (45.71)	0.038	0.845
Combined diabetes	22 (27.50)	18 (25.71)	0.05	0.824

P < 0.05 indicated significant difference. TNM: Tumor-node-metastasis.

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Table 2 Monitoring of postoperative complications, n (%)

Complications	Time point	Abdominal obesity group (n = 80)	Non-abdominal obesity group (n = 70)	χ²/t	P value
Pulmonary infection	Day 1	10 (12.50)	4 (5.71)	2.031	0.154
Pulmonary infection	Day 3	16 (20.00)	6 (8.57)	4.319	0.038
Incision infection	Day 3	7 (8.75)	3 (4.29)	1.132	0.287
Urinary system infection	Day 3	6 (7.50)	2 (2.86)	1.392	0.238
Intestinal obstruction	Day 7	7 (8.75)	3 (4.29)	1.132	0.287
Anastomotic leakage	Day 7	8 (10.00)	2 (2.86)	4.121	0.042
Postoperative haemorrhage	Before discharge	5 (6.25)	1 (1.43)	2.143	0.143
Deep vein thrombosis	Before discharge	4 (5.00)	0 (0.00)	3.677	0.055
Clavien-Dindo class ≥ III	Before discharge	15 (18.75)	5 (7.14)	4.726	0.03

P < 0.05 indicated significant difference.

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Table 3 Detection of biochemical indicators, mean ± SD

Time point	Abdominal obesity group (n = 80)	Non-abdominal obesity group (n = 70)	χ²/t	P value
WBC count (× 10⁹/L)
1 day before surgery	7.45 ± 1.25	6.80 ± 1.10	2.136	0.034
Day 1	10.24 ± 2.43	9.02 ± 1.98	2.463	0.015
Day 3	9.90 ± 2.10	8.60 ± 1.85	2.184	0.03
Day 7	9.05 ± 1.85	7.80 ± 1.50	2.632	0.01
NEUT%
1 day before surgery	63.50 ± 8.40	60.75 ± 7.90	2.182	0.031
Day 1	72.45 ± 9.50	68.60 ± 8.30	2.104	0.037
Day 3	69.80 ± 8.30	65.30 ± 7.00	2.545	0.013
Day 7	68.20 ± 7.80	64.10 ± 6.90	2.391	0.018
CRP (mg/L)
1 day before surgery	5.35 ± 1.85	4.90 ± 1.20	1.983	0.048
Day 1	21.50 ± 8.75	18.80 ± 7.60	2.465	0.015
Day 3	16.75 ± 6.10	14.90 ± 5.30	2.305	0.022
Day 7	11.25 ± 4.90	9.80 ± 4.20	2.438	0.016
ALB (g/L)
1 day before surgery	38.75 ± 5.40	40.00 ± 4.20	1.621	0.107
Day 1	31.50 ± 5.30	33.20 ± 4.70	2.264	0.024
Day 3	34.00 ± 4.80	35.20 ± 4.30	1.847	0.067
Day 7	36.50 ± 4.00	37.30 ± 3.80	1.472	0.142
TP (g/L)
1 day before surgery	60.00 ± 5.10	61.30 ± 4.60	1.174	0.242
Day 1	57.20 ± 5.80	58.10 ± 5.30	1.132	0.258
Day 3	58.00 ± 6.00	59.50 ± 5.80	1.059	0.291
Day 7	59.20 ± 5.60	60.00 ± 5.40	1.312	0.191

P < 0.05 indicated significant difference. WBC: White blood cell; NEUT%: Neutrophil percentage; CRP: C-reactive protein; ALB: Albumin; TP: Total protein.

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Table 4 Detection of tumor markers, mean ± SD

Time point	Abdominal obesity group (n = 80)	Non-abdominal obesity group (n = 70)	χ²/t	P value
CEA (ng/mL)
1 day before surgery	3.90 ± 1.15	3.70 ± 1.00	1.001	0.318
Day 7	5.80 ± 2.30	5.20 ± 2.00	1.402	0.162
Month 3	6.10 ± 2.40	5.30 ± 2.10	2.092	0.039
CA19-9 (U/mL)
1 day before surgery	32.50 ± 5.80	30.20 ± 4.50	2.136	0.034
Day 7	35.00 ± 6.20	33.10 ± 5.70	1.21	0.227
Month 3	37.00 ± 6.80	34.60 ± 5.40	1.983	0.048

P < 0.05 indicated significant difference. CEA: Carcinoembryonic antigen; CA19-9: Carbohydrate antigen 19-9.

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Table 5 Imaging follow-up evaluation, n (%)

Time point	Abdominal obesity group (n = 80)	Non-abdominal obesity group (n = 70)	χ²/t	P value
Postoperative day 30	Local recurrence: 15 (18.75)	Local recurrence: 7 (10.00)	3.984	0.046
	Distant metastasis: 6 (7.50)	Distant metastasis: 4 (5.71)	1.123	0.29
	Poor recovery in the operation area: 4 (5.00)	Poor recovery in the operation area: 3 (4.29)	0.978	0.323
	Good recovery was achieved in the operation area: 55 (68.75)	Good recovery was achieved in the operation area: 56 (80.00)	2.586	0.108
3 months after surgery	Local recurrence: 18 (22.50)	Local recurrence: 9 (12.86)	4.351	0.037
	Distant metastasis: 7 (8.75)	Distant metastasis: 5 (7.14)	0.743	0.389
	Poor recovery in the operation area: 5 (6.25)	Poor recovery in the operation area: 3 (4.29)	1.169	0.28
	Good recovery was achieved in the operation area: 50 (62.50)	Good recovery was achieved in the operation area: 53 (75.71)	2.833	0.092

P < 0.05 indicated significant difference.

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Table 6 Status of nutrition and recovery indicators, mean ± SD

Time point	Abdominal obesity group (n = 80)	Non-abdominal obesity group (n = 70)	χ²/t	P value
Dietary intake and body weight change (kcal)
Day 1	1200.00 ± 150.00	1300.00 ± 180.00	1.607	0.115
Day 7	1300.00 ± 160.00	1400.00 ± 170.00	2.026	0.043
Body weight change (kg)	-2.80 ± 0.90	-2.20 ± 0.80	2.213	0.029
Gastrointestinal function recovery (exhaust and defecation time) (hour)
Day 3	48.00 ± 12.00	42.00 ± 10.00	2.078	0.038
Day 7	72.00 ± 14.00	65.00 ± 13.00	2.075	0.042
PG-SGA scale
Week 1	8.30 ± 2.10	7.20 ± 1.90	2.136	0.032
Week 4	9.10 ± 2.30	7.80 ± 2.10	2.369	0.021

P < 0.05 indicated significant difference. PG-SGA: Patient-Generated Subject Global Assessment.

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Table 7 Results of logistic regression analysis

Factor	β	SE	Wald χ²	P value	OR	95%CI
Constant term	-0.564	0.245	5.178	0.023	0.569	0.332-0.979
Abdominal obesity (yes)	1.345	0.412	10.512	0.001	3.843	1.750-8.451
Age (1 year for each additional)	0.032	0.021	2.227	0.136	1.033	0.991-1.077
BMI (per 1 kg/m² increase)	0.089	0.036	6.165	0.013	1.093	1.018-1.174
Combined basic disease (yes)	0.512	0.265	3.693	0.055	1.668	0.986-2.808

P < 0.05 indicated significant difference. BMI: Body mass index; OR: Odds ratio; 95%CI: 95% confidence interval.

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Table 8 Cox risk regression analysis results

Factor	β	P value	HR	95%CI
OS
Constant term	-1.14	0.004	0.32	-
Abdominal obesity (yes)	0.661	0.011	1.937	1.158-3.243
Pathological staging (III)	1.079	0.001	2.941	1.606-5.388
Adjuvant treatment (no)	0.794	0.007	2.212	1.237-3.954
DFS
Constant term	-0.921	0.012	0.398	-
Abdominal obesity (yes)	0.57	0.018	1.769	1.102-2.842
Pathological staging (III)	1.147	< 0.001	3.15	1.778-5.582

P < 0.05 indicated significant difference. OS: Overall survival; DFS: Disease-free survival; HR: Hazard ratio; 95%CI: 95% confidence interval.

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Citation: Zhou J, Wang BP, Su RN, Zhang S, Gao YW. Impact of visceral obesity on postoperative complications and oncological outcomes in elderly patients with colorectal cancer. World J Gastrointest Oncol 2026; 18(1): 109735
URL: https://www.wjgnet.com/1948-5204/full/v18/i1/109735.htm
DOI: https://dx.doi.org/10.4251/wjgo.v18.i1.109735