Impact of being overweight on the surgical outcomes of patients with gastric cancer: A meta-analysis

Wu, Xia; Wu, Weiping; Li, Maolan; Yang, Jingsi; Ding, Qichen; Zhang, Lin; Mu, Jian; Gu, Jun; Dong, Ping; Lu, Jianhua; Liu, Yingbin

doi:10.3748/wjg.v19.i27.4596

Cited by 59 publications

(45 citation statements)

References 49 publications

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“…Due to the high rate of comorbidities, obesity is frequently considered to represent a major risk factor for complications after surgery. Previous reports have identified postoperative complications correlating with a high BMI [4,15,17] . However, with regard to colorectal carcinoma, it was shown that a high BMI does not affect oncologic outcomes after surgery [18] .…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, patients lose weight after gastrectomy to the extent that they begin to suffer from malnutrition [10,11] . Although a low BMI has been thought to be associated with a better short-term outcome than a high BMI due to simplicity and steadiness of surgical procedure [4] , the long-term outcome in low-BMI patients has remained unclear.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, it is thought that the volume of blood loss and operation time often depend on the accu-mulated fat. In addition a meta-analysis reported that obesity is a risk factor for pancreatic fistula formation, leakage and prolonged operation time and that fewer lymph nodes are retrieved in overweight patients [4] . However, previous authors have shown that the BMI does not affect postoperative morbidity after gastrectomy [5,6] , and other recent studies have suggested that obesity may be correlated with a favorable long-term prognosis [7][8][9] .…”

Section: Introductionmentioning

confidence: 99%

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Implications of BMI for the Prognosis of Gastric Cancer among the Japanese Population

et al. 2015

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Background: The clinical significance of body mass index (BMI) on the surgical outcomes in gastric cancer patients still remains controversial. Methods: The subjects included 427 patients who underwent gastrectomy between January 2001 and December 2005. The patients were principally divided into 3 groups on the basis of BMI: low (<18.5 kg/m²), normal (≥18.5-<25.0 kg/m²) and high (≥25.0 kg/m²). Results: The low-BMI patients had more advanced disease than the other patients. There were no statistically significant differences in the characteristics of the normal- and high-BMI patients. The operation time was longer in the high-BMI group, but there were no differences in terms of lymph node dissection and postoperative complications among these 3 groups. The overall survival and disease-specific survival of the low-BMI group were worse than the other 2 groups. These survival rates of high-BMI group tended to be better than those of the normal BMI group; however, it was not statistically different. A multivariate analysis of these survival rate showed that a low BMI was an independent predictor of a poor prognosis. Conclusions: A low-BMI was an independent factor of poor prognosis for overall and disease-specific survivals after surgery in Japanese patients with gastric cancer. A high-BMI was not a risk factor.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implications of BMI for the Prognosis of Gastric Cancer among the Japanese Population

et al. 2015

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“…Although there are published studies that have investigated the relationship between BMI and complications, the results of these studies have been inconsistent [5][6][7]14]. Moreover, in their meta-analysis, Wu et al [15] demonstrated that obesity only increased the risk of postoperative complications and prolonged the duration of hospitalization, but obesity did not affect the total number of excised lymph nodes. Intra-operational time, the need for blood transfusions, and the number of excised lymph nodes were determined to be surgical challenges within the scope of our study; no differences, however, were found among the groups.…”

Section: Discussionmentioning

confidence: 99%

The Effects of Body Mass Index on Lymph Node Dissection and Complications in Total Gastrectomy

Gündeş

Aday

Çiyiltepe

et al. 2018

ijmsci

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Abstract:Objective; The aim of this study was to investigate the effects of body mass index (BMI) on postoperative complications and on the total number of excised and metastatic lymph nodes in cases with total gastrectomy + D2 lymph node dissections because of gastric cancer. Methods: The patients were divided into three groups according to their BMI: those with BMI of 24.9 (kg/m2) and less were normal (Group 1), those with BMI between 25 and 30 (kg/m2) were overweight (Group 2), and those with BMI greater than 30 (kg/m2) were obese (Group 3). Results: There were 27 patients in Group I, 28 in Group 2 and 25 in Group 3. When the groups were examined, only Group 3 had a higher rate of comorbidity. Otherwise, the clinical characteristics and the rates of intraoperative and postoperative complications were similar among the groups. The pathological analyses conducted among the groups revealed that BMI had no effect on the number of excised lymph nodes, the number of metastatic lymph nodes, and the ratio of metastatic lymph nodes to excised lymph nodes. Conclusion: We believe that BMI does not affect pathological outcomes in gastric cancer surgery and does not increase surgical complications.

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“…Obesity has generally been regarded as a poor prognostic factor for the intraoperative and postoperative outcomes following gastric cancer 2,3) . One of the reasons for this is higher local recurrence because complete lymph node dissection is difficult in gastric cancer patients with obesity 2,4) .…”

mentioning

confidence: 99%

Letter to the Editor: Is There an Obesity Paradox in Diabetic Patients Undergoing Subtotal Gastrectomy for Gastric Cancer?

Choi

2017

Ann Geriatr Med Res

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Impact of being overweight on the surgical outcomes of patients with gastric cancer: A meta-analysis

Abstract: This meta-analysis demonstrates that a high BMI not only increases the surgical difficulty and complications but also impairs the long-term survival of patients with gastric cancer.

Cited by 59 publications

References 49 publications

Implications of BMI for the Prognosis of Gastric Cancer among the Japanese Population

Implications of BMI for the Prognosis of Gastric Cancer among the Japanese Population

The Effects of Body Mass Index on Lymph Node Dissection and Complications in Total Gastrectomy

Letter to the Editor: Is There an Obesity Paradox in Diabetic Patients Undergoing Subtotal Gastrectomy for Gastric Cancer?

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