{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T14:13:37Z","timestamp":1778854417171,"version":"3.51.4"},"reference-count":25,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,19]],"date-time":"2025-12-19T00:00:00Z","timestamp":1766102400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Annals of Gastroent Surgery"],"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>With global rising rates of obesity, surgeries for colorectal cancer (CRC) in obese patients are increasingly common. Although obesity may complicate surgical procedures and oncologically unbeneficial, its true clinical impact remains unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with stage I\u2013IV CRC who underwent surgical resection between 2017 and 2019 were enrolled from a prefecture\u2010wide multicenter database. Patients were categorized based on body mass index (BMI) into non\u2010obesity (BMI &lt;\u200925\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), mild\u2010obesity (BMI \u2265\u200925 and &lt;\u200930\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ), and severe\u2010obesity (BMI \u2265\u200930\u2009kg\/m\n                      <jats:sup>2<\/jats:sup>\n                      ) groups. Perioperative outcomes, long\u2010term survival, and lymph node metrics, including the log odds of positive lymph nodes (LODDS).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 2905 patients, 2283 were non\u2010obesity, 576 mild\u2010obesity, and 91 severe\u2010obesity. Younger, more often male, and had higher American Society of Anesthesiologists (ASA) class and Charlson Comorbidity Index scores are included in obesity group. Operative time and blood loss increased with BMI, while the number of retrieved lymph nodes and D3 dissection rates declined. Postoperative complications and hospital stay showed no significant differences. While recurrence\u2010free survival (RFS) and overall survival (OS) were comparable across BMI groups, obese patients had a higher proportion of LODDS \u2265\u2009\u22120.7. In stage III patients, LODDS \u2265\u2009\u22120.7 was more strongly associated with recurrence and poor prognosis in the obese subgroup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Obesity is associated with increased surgical complexity and limited pathological lymph node evaluation. Among stage III CRC patients, impaired nodal stratification\u2014as reflected by elevated LODDS\u2014may contribute to poorer prognosis in the obese population, highlighting the need for tailored oncological strategies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ags3.70156","type":"journal-article","created":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T05:32:04Z","timestamp":1766208724000},"page":"748-759","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Perioperative and Oncological Outcomes of Colorectal Cancer Surgery in Obese Patients: A Multicenter Retrospective Study"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1049-4203","authenticated-orcid":false,"given":"Kazuhiro","family":"Taguchi","sequence":"first","affiliation":[{"name":"Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Manabu","family":"Shimomura","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological and Transplant Surgery, Graduate School of Biomedical and Health Sciences Hiroshima University  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wataru","family":"Shimizu","sequence":"additional","affiliation":[{"name":"Department of Surgery Hiroshima City North Medical Center Asa Citizens Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Satoshi","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery Hiroshima Prefectural Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Yoshimitsu","sequence":"additional","affiliation":[{"name":"Department of Surgery Hiroshima City Hiroshima Citizens Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohei","family":"Kouyama","sequence":"additional","affiliation":[{"name":"Department of Surgery Hiroshima General Hospital  Hatsukaichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahiro","family":"Nakahara","sequence":"additional","affiliation":[{"name":"Department of Surgery Onomichi General Hospital  Onomichi Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hironori","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Surgery Hiroshima Memorial Hospital  Hiroshima Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masatoshi","family":"Kochi","sequence":"additional","affiliation":[{"name":"Department of Gastroenterological Surgery National Hospital Organization Higashihiroshima Medical Center  Higashihiroshima 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