Implications of overweight in gastric cancer: A multicenter study in a Western patient population

• Published in: European journal of surgical oncology Vol. 36; no. 10; pp. 969 - 976
• Main Authors: Kulig, J, Sierzega, M, Kolodziejczyk, P, Dadan, J, Drews, M, Fraczek, M, Jeziorski, A, Krawczyk, M, Starzynska, T, Wallner, G
• Format: Journal Article
• Language: English
• Published: England Elsevier Ltd 01.10.2010; WB Saunders
• Subjects: Body Mass Index; Cohort Studies; Comorbidity; Female; Follow-Up Studies; Gastrectomy - methods; Gastrectomy - mortality; Gastric cancer; Hematology, Oncology and Palliative Medicine; History, Medieval; Humans; Kaplan-Meier Estimate; Lymph node dissection; Male; Multivariate Analysis; Neoplasm Staging; Obesity - mortality; Overweight; Overweight - mortality; Poland; Postoperative complications; Postoperative Complications - mortality; Postoperative Complications - physiopathology; Prognosis; Proportional Hazards Models; Registries; Retrospective Studies; Risk Assessment; Statistics, Nonparametric; Stomach Neoplasms - mortality; Stomach Neoplasms - pathology; Stomach Neoplasms - surgery; Surgery; Treatment Outcome; Poland; Body mass index; Prognosis; Lymph node dissection; Gastric cancer; Postoperative complications; Overweight; postoperative complications; lymph node dissection; gastric cancer; overweight; prognosis; body mass index
• ISSN: 0748-7983; 1532-2157
• DOI: 10.1016/j.ejso.2010.07.007

Abstract Aims The purpose of this study was to evaluate the effects of overweight on surgical and long-term outcomes in a Western population of patients with gastric cancer (GC). Methods An electronic database of all patients with resectable GC treated between 1986 and 1998 at seven university surgical centres cooperating in the Polish Gastric Cancer Study Group was reviewed. Overweight was defined as a body mass index (BMI) of 25 kg/m2 or higher. Results Four hundred and ninety-two of 1992 (25%) patients were overweight. Postoperatively, higher BMI was associated with higher rates of cardiopulmonary complications (16% vs 12%, P  = 0.001) and intra-abdominal abscess (6.9% vs 2.9%, P  < 0.001). However, other complications and mortality rates were unaffected. The median disease-specific survival of overweight patients was significantly higher (36.7 months, 95% confidence interval (CI) 29.0–44.4) than those with BMI<25 kg/m2 (25.7 months, 95%CI 23.2–28.1; P  = 0.003). These differences were due to the lower frequencies of patients with T3 and T4 tumours, metastatic lymph nodes, distant metastases, and non-curative resections. A Cox proportional hazards model identified age, depth of infiltration, lymph node metastases, distant metastases, and residual tumour category as the independent prognostic factors. Conclusions Overweight is not the independent prognostic factor for long-term survival in a Western-type population of GC.