Visceral fat area and blood lipids in colorectal cancer: predictors of surgical risk and prognosis

ObjectiveThis 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).MethodsWe 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.ResultsThe 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.ConclusionThe 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.