Objective This study aimed to evaluate the predictive value of combining visceral fat area (VFA) with blood lipid levels for perioperative risk and long-term prognosis in patients undergoing radical resection for colorectal cancer (CRC). Methods We conducted a retrospective analysis of 482 CRC patients who underwent radical surgery between December 2014 and December 2022. Patients were categorized into four groups based on VFA (visceral obesity defined as VFA ≥ 100 cm²) and lipid levels (elevated: TC ≥ 6.2 mmol/L, LDL-C ≥ 4.1 mmol/L, TG ≥ 2.3 mmol/L, or HDL-C 1.0 mmol/L). Baseline characteristics, surgical outcomes, and survival data were compared. Multivariate logistic and Cox regression models were used to identify independent factors influencing complications and survival. Results The combined VFA/lipid groups showed no significant differences in short-term complications ( P 0.05) but demonstrated significant stratification in long-term survival. Patients with both high VFA and high lipid levels (Group 2) exhibited significantly better overall survival (OS) and recurrence-free survival (RFS) compared to those with low VFA and normal lipids (HR ≈ 0.50, P 0.01), supporting the “obesity paradox.” Age, TNM stage, and surgical approach were also identified as independent prognostic factors. Conclusion The combination of VFA and blood lipid levels may serve as a useful preoperative indicator for risk stratification and prognostic assessment in CRC patients, with high VFA and high lipids potentially associated with improved survival outcomes.
Wang et al. (Mon,) studied this question.