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Excess of weight: is it a modifiable predictive and prognostic factor in locally advanced rectal cancer?

OBJECTIVE: To evaluate the relationship between body mass index (BMI) and rates of treatment tolerance and clinical outcomes in patients with locally advanced rectal cancer treated with a multimodality approach.

PATIENTS AND METHODS: This study was conducted on 56 patients with histologically proven rectal adenocarcinoma, staged T3-4, and/or node-positive tumor, which underwent intensified radiochemotherapy (RT-CHT) treatment before surgery. We calculated adiposity indices and analyzed their influence on treatment tolerance and clinical outcomes.

RESULTS: Distribution of the 56 patients according to BMI was BMI < 25 kg/m2 (n = 19; 33.9%), BMI 25-29 kg/m2 (n = 29; 51.8%) and BMI ≥ 30 kg/m2 (n = 8; 14.3%). BMI had no significant influence on neo-adjuvant treatment-related toxicity. With a median follow-up of 23 months (range 11-47), the 2-year survival was 85.7%. We did not observe any significant difference among the three BMI categories for any of the outcomes.

CONCLUSIONS: This study suggested no evident links between overweight and survival in patients with locally advanced rectal carcinoma treated with neo-adjuvant RT-CHT. Overweight patients tolerate treatment as normal-weight patients.

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