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• Publicatie DCRA in European Journal of Surgical Oncology

Publicatie met data uit de Dutch ColoRectal Audit (DCRA) in het European Journal of Surgical Oncology:

Obesity as a determinant of perioperative and postoperative outcome in patients following colorectal cancer surgery: A population-based study (2009-2016).

Auteurs: Y.Q.M. Poelemeijer, N. Lijftogt, R. Detering, M. Fiocco, R.A.E.M. Tollenaar & M.W.J.M. Wouters.

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Background: Obesity is an increasing problem worldwide that can influence perioperative and post- operative outcomes. However, the relationship between obesity and treatment-related perioperative and short-term postoperative morbidity after colorectal resections is still subject to debate.

Study: Patients were selected from the DCRA, a population-based audit including 83 hospitals per- forming colorectal cancer (CRC) surgery. Data regarding primary resections between 2009 and 2016 were eligible for analyses. Patients were subdivided into six categories: underweight, normal weight, over- weight and obesity class I, II and III.

Results: Of 71,084 patients, 17.7% with colon and 16.4% with rectal cancer were categorized as obese. Significant differences were found for the 30-day overall postoperative complication rate (p < 0.001), prolonged hospitalization (p < 0.001) and readmission rate (colon cancer p < 0.005; rectal cancer p < 0.002) in obese CRC patients. Multivariate analysis identified BMI !30 kg/m2 as independent pre- dictor of a complicated postoperative course in CRC patients. Furthermore, obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher read- mission rate. No significant differences in performance were observed in postoperative outcomes of morbidly obese CRC patients between hospitals performing bariatric surgery and hospitals that did not.

Conclusion: The real-life data analysed in this study reflect daily practice in the Netherlands and identify obesity as a significant risk factor in CRC patients. Obesity-related comorbidities were associated with higher postoperative morbidity, prolonged hospitalization and a higher readmission rate in obese CRC patients. No differences were observed between hospitals performing bariatric surgery and hospitals that did not.