Impact of obesity on presentation of colorectal cancer
Bibliographic record
Abstract
3645 Background: Obesity has been shown to be associated with reduced survival in patients with colorectal cancer, although mechanisms for this finding are unclear. We hypothesized that, at least in part, this may be due to obesity-associated differences in presentation. Thus, the objective of this study was to examine the impact of obesity on the presentation and pathologic staging of colorectal cancer. Methods: From 02/15/2002 to 02/15/2004, all patients undergoing surgery for primary colorectal cancer at two institutions were enrolled in a prospective cohort study. Body mass index (BMI) was measured at the time of hospital admission for surgery. National Institutes of Health criteria were used to categorize patients: normal/underweight (NW; 18.4 < BMI < 25 kg/m2), overweight (OW; BMI = 25–29.9 kg/m2), obese (OB; BMI = 30–39.9 kg/m2) and severely obese (SOB; BMI> 40 kg/m2). Presentation and pathologic factors were then compared among the groups. Results: The study cohort consisted of 448 patients; 125 (27.9%) were NW, 172 (38.4%) were OW, 127 (28.3%) were OB, and 24 (5.4%) were SOB. No significant differences in age, gender, ethnicity, or tumor grade were found between weight groups. Most patients (90.8%) presented with symptomatic disease; the use of colorectal cancer screening was similar among all weight groups. Among symptomatic patients, bleeding/anemia as the first presenting symptom was significantly associated with increasing BMI (see table). SOB patients were found to have a significantly increased incidence of lymph node metastases, whereas NW patients were more likely to present with metastatic disease (see table). Conclusions: This study identified several obesity-related differences in presentation of colorectal cancer. An obesity-associated increased incidence of node metastases was seen only in the small proportion of obese patients who are SOB. The increased incidence of metastatic disease at presentation among NW patients may reflect disease-related weight loss. No significant financial relationships to disclose.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".