eISSN: 1897-4252
ISSN: 1731-5530
Kardiochirurgia i Torakochirurgia Polska/Polish Journal of Thoracic and Cardiovascular Surgery
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1/2024
vol. 21
 
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abstract:
Original paper

The relation of body adiposity to the outcomes of thoracoscopic lobectomy for lung cancer – a single-center cohort study

Piotr Gabryel
1
,
Piotr Skrzypczak
1
,
Lidia Szlanga
1
,
Aleksandra Kaluzniak-Szymanowska
2
,
Magdalena Sielewicz
1
,
Alessio Campisi
3
,
Magdalena Roszak
4
,
Cezary Piwkowski
1

  1. Department of Thoracic Surgery, Poznan University of Medical Sciences, Poznan, Poland
  2. Department of Palliative Medicine, Poznan University of Medical Sciences, Poznan, Poland
  3. Department of Thoracic Surgery, University and Hospital Trust–Ospedale Borgo Trento, Verona, Italy
  4. Department of Computer Science and Statistics, Poznan University of Medical Sciences, Poznan, Poland
Kardiochirurgia i Torakochirurgia Polska 2024; 21 (1): 8-14
DOI: https://doi.org/10.5114/kitp.2024.138524
Online publish date: 2024/03/30
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Introduction
The outcomes of lung cancer surgery depend on the patients’ nutritional status. Body fat percentage (BF%) is one of the indicators of body composition and nutritional status. Direct measurement of BF% is complicated, requires significant resources and is rarely performed. The CUN-BAE (Clínica Universidad de Navarra – Body Adiposity Estimator) index has been shown to accurately predict BF% is several clinical settings, but its relation to the outcomes of lung surgery has not been reported so far.

Aim
To determine the relation of the BF% to the outcomes of thoracoscopic lobectomy.

Material and methods
This retrospective study included 1,183 patients who underwent thoracoscopic lobectomy for non-small cell lung cancer between June 1999, and September 2019 at one department. BF% was calculated according to the Clínica Universidad de Navarra – Body Adiposity Estimator equation. The primary endpoints were postoperative complications and long-term survival.

Results
Univariate analysis showed that higher BF% was related to lower incidence of complications (p = 0.001), including prolonged air leak (p < 0.001), atelectasis (p < 0.05), psychosis (p < 0.001), reoperations (p < 0.05), and shorter chest drainage (p = 0.001) and hospitalization duration (p < 0.001). Multivariate analysis showed that higher BF% was correlated with lower risk of complications (p = 0.005; OR = 0.964; 95% CI: 0.940 to 0.989), including prolonged air leak (p < 0.001; OR = 0.923; 95% CI: 0.886 to 0.962), and shorter duration of chest drainage (p < 0.001; B = –0.046; 95% CI: –0.069 to –0.023) and hospitalization (p < 0.001; B = –0.112; 95% CI: –0.176 to –0.048). Cox proportional hazards regression analysis showed that BF% was not related to long-term survival.

Conclusions
Body fat percentage is a valuable tool that can help predict the short-term outcomes of minimally lobectomy for lung cancer.

keywords:

lung cancer surgery, minimally invasive surgery, thoracoscopy/video-assisted thoracoscopic surgery, obesity, body fat
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