Impact of Body Mass Index on Survival Depending on Sex in 14,688 Patients with Gastric Cancer in a Tertiary Hospital in South Korea

Jo, Hyeong Ho; Kim, Na Young; Jang, Jieun; Choi, Yonghoon; Park, Jaehyung; Park, Young Mi; Ahn, Soyeon; Yoon, Hyuk; Shin, Cheol Min; Park, Young Soo; Lee, Dong Ho; Oh, Hyeon Jeong; Lee, Hye Seung; Park, Young Suk; Ahn, Sang-Hoon; Suh, Yun-Suhk; Park, Do Joong; Kim, Hyung‐Ho; Kim, Ji-Won; Kim, Jin Won; Lee, Keun-Wook; Chang, Won; Park, Ji Hoon; Lee, Yoon Jin; Lee, Kyung Ho; Kim, Young Hoon

doi:10.5009/gnl220104

Cited by 6 publications

(4 citation statements)

References 52 publications

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“…Therefore, there was a limitation that p53, EBV, atrophic gastritis, intestinal metaplasia, H. pylori and its eradication treatment which are related with GC, 28 were not performed consistently. 29 , 30 Although the data are not clean in comparison to complete prospective design, we tried to minimize selection bias during the very long period. In addition, 13% of cases lacked pathological dates mainly because surgery could not be performed or surgery was refused, especially in the old age or in the presence of other serious diseases.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Characteristics and Risk Factors of Patients with Single Gastric Cancer and Synchronous Multiple Gastric Cancer among 14,603 Patients

Song

Kim

et al. 2023

Gut and Liver

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Background/Aims: Synchronous multiple gastric cancer (SMGC) accounts for approximately 6% to 14% of gastric cancer (GC) cases. This study aimed to identify risk factors for SMGC.Methods: A total of 14,603 patients diagnosed with GC were prospectively enrolled. Data including age, sex, body mass index, smoking, alcohol consumption, family history, p53 expression, microsatellite instability, cancer classification, lymph node metastasis, and treatment were collected. Risk factors were analyzed using logistic regression analysis between a single GC and SMGC. Results:The incidence of SMGC was 4.04%, and that of early GC (EGC) and advanced GC (AGC) was 5.43% and 3.11%, respectively. Patients with SMGC were older (65.33 years vs 61.75 years, p<0.001) and more likely to be male. Lymph node metastasis was found in 27% of patients with SMGC and 32% of patients with single GC. Multivariate analysis showed that SMGC was associated with sex (male odds ratio [OR], 1.669; 95% confidence interval [CI], 1.223 to 2.278; p=0.001), age (≥65 years OR, 1.532; 95% CI, 1.169 to 2.008; p=0.002), and EGC (OR, 1.929; 95% CI, 1.432 to 2.600; p<0.001). Survival rates were affected by Lauren classification, sex, tumor size, cancer type, distant metastasis, and venous invasion but were not related to the number of GCs. However, the survival rate of AGC with SMGC was very high.Conclusions: SMGC had unique characteristics such as male sex, older age, and EGC, and the survival rate of AGC, in which the intestinal type was much more frequent, was very good (Trial registration number: NCT04973631).

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Section: Discussionmentioning

confidence: 99%

Analysis of Characteristics and Risk Factors of Patients with Single Gastric Cancer and Synchronous Multiple Gastric Cancer among 14,603 Patients

Song

Kim

et al. 2023

Gut and Liver

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“…Another notable result of this study is the observed association between normal weight and an increased risk of GC in women aged 50 years and older. Recent reports have indicated a rise in GC risk among both underweight and overweight individuals, forming a so-called "U-shaped pattern" [12,40]. While the link between overweight, obesity, and GC risk has been described previously, it appears that being underweight or of normal weight also increases GC risk compared to those who are overweight.…”

Section: Interpretation and Comparison With Previous Researchmentioning

confidence: 92%

“…To date, the causal relationship or sequence of events linking underweight or normal weight with GC risk remains unclear. Moreover, one previous study found an association between underweight and non-cardia cancer [12], while another study reported a link between underweight and cardia cancer [40], indicating some inconsistencies in the findings. In conclusion, when investigating the correlation between obesity and GC risk, it is essential to consider not only sex but also age and the anatomical location of the cancer.…”

Section: Interpretation and Comparison With Previous Researchmentioning

confidence: 93%

Effect of body mass index on gastric cancer risk according to sex in Korea: a nationwide cohort study and literature review

Choi,

Jang,

Kim

2024

Ewha Med J

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Objectives: Gastric cancer (GC) demonstrates a sex disparity that may also be associated with body mass index (BMI). This study explored whether the effect of BMI on the risk of GC varies by sex. Methods:The study cohort included 341,999 Koreans aged 40 years or older from the National Health Insurance Service-Health Screening Cohort, with a median follow-up period of 10 years. Participants were categorized into five groups based on their BMI. The effect of BMI was evaluated using Cox proportional hazard regression. Additionally, stratification analysis was performed according to waist circumference.Results: An increased risk of developing GC was observed across the study population among those with obesity (BMI 25.0-29.9 kg/m 2 ; hazard ratio [HR], 1.11; 95% CI , 1.03-1.20) and severe obesity (BMI ≥30.0 kg/m 2 ; HR, 1.22; 95% CI, 1.01-1.47), considering a 2-year latency period. Notably, the rise in GC risk was particularly pronounced among women with obesity and men with severe obesity. In the age-stratified analysis, severe obesity (BMI ≥30.0 kg/m 2 ) was associated with an increased risk of GC in men under 50 years old (HR, 1.83; 95% CI, 0.99-3.37). For individuals aged ≥50 years, obesity was linked to a heightened risk of GC in both sexes. Furthermore, normal BMI (18.5-22.9 kg/m 2 ) was associated with an increased GC risk in women. Conclusion:These findings indicate a positive association between excess body weight and the risk of GC in Koreans, particularly among men with severe obesity.

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“…The association between overweight/obesity and cancer risk, however, is not always consistent: for example, overweight and obesity prior to menopause decreases the risk of premenopausal breast cancer, and during the period of 18-30 years of age, it decreases the risk of pre-and postmenopausal breast cancer [10]. Furthermore, increasing evidence has been observed in different studies that the overweight condition may be a protective factor for overall survival after neoadjuvant therapy and surgical resection in oesophageal cancer [11]; after the immunotherapy treatment of renal cell carcinoma (RCC) [12]; for overall survival, disease-free survival and cancer-specific survival in colorectal cancer (CRC) [13] and for a better prognosis in other types of cancer [14][15][16][17][18][19]. A systematic review and a meta-analysis of 203 studies considering 6.3 million cancer patients showed that obesity was associated with higher overall mortality in breast, CRC and endometrial cancer [20].…”

Section: Of 25mentioning

confidence: 99%

Obesity, the Adipose Organ and Cancer in Humans: Association or Causation?

et al. 2023

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Epidemiological observations, experimental studies and clinical data show that obesity is associated with a higher risk of developing different types of cancer; however, proof of a cause–effect relationship that meets the causality criteria is still lacking. Several data suggest that the adipose organ could be the protagonist in this crosstalk. In particular, the adipose tissue (AT) alterations occurring in obesity parallel some tumour behaviours, such as their theoretically unlimited expandability, infiltration capacity, angiogenesis regulation, local and systemic inflammation and changes to the immunometabolism and secretome. Moreover, AT and cancer share similar morpho-functional units which regulate tissue expansion: the adiponiche and tumour-niche, respectively. Through direct and indirect interactions involving different cellular types and molecular mechanisms, the obesity-altered adiponiche contributes to cancer development, progression, metastasis and chemoresistance. Moreover, modifications to the gut microbiome and circadian rhythm disruption also play important roles. Clinical studies clearly demonstrate that weight loss is associated with a decreased risk of developing obesity-related cancers, matching the reverse-causality criteria and providing a causality correlation between the two variables. Here, we provide an overview of the methodological, epidemiological and pathophysiological aspects, with a special focus on clinical implications for cancer risk and prognosis and potential therapeutic interventions.

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Impact of Body Mass Index on Survival Depending on Sex in 14,688 Patients with Gastric Cancer in a Tertiary Hospital in South Korea

Abstract: Background/Aims: The incidence and prognosis of gastric cancer (GC) shows sex difference. This study aimed to evaluate the effect of body mass index (BMI) on GC survival depending on sex.

Cited by 6 publications

References 52 publications

Analysis of Characteristics and Risk Factors of Patients with Single Gastric Cancer and Synchronous Multiple Gastric Cancer among 14,603 Patients

Analysis of Characteristics and Risk Factors of Patients with Single Gastric Cancer and Synchronous Multiple Gastric Cancer among 14,603 Patients

Effect of body mass index on gastric cancer risk according to sex in Korea: a nationwide cohort study and literature review

Obesity, the Adipose Organ and Cancer in Humans: Association or Causation?

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