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

Eur J Surg Oncol. 2010 Oct;36(10):969-76. doi: 10.1016/j.ejso.2010.07.007. Epub 2010 Aug 21.

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/m(2) 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/m(2) (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.

Publication types

  • Comparative Study
  • Historical Article
  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Body Mass Index*
  • Cohort Studies
  • Comorbidity
  • Female
  • Follow-Up Studies
  • Gastrectomy / methods
  • Gastrectomy / mortality
  • History, Medieval
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Multivariate Analysis
  • Neoplasm Staging
  • Obesity / mortality
  • Overweight / mortality*
  • Poland
  • Postoperative Complications / mortality
  • Postoperative Complications / physiopathology
  • Proportional Hazards Models
  • Registries
  • Retrospective Studies
  • Risk Assessment
  • Statistics, Nonparametric
  • Stomach Neoplasms / mortality*
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*
  • Treatment Outcome