Impact of Obesity on Perioperative Complications and Long-term Survival of Patients with Gastric Cancer

Bickenbach, Kai; Denton, Brian T.; Gönen, Mithat; Brennan, Murray F.; Coit, Daniel G.; Strong, Vivian E.

doi:10.1245/s10434-012-2653-3

Cited by 108 publications

(89 citation statements)

References 34 publications

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“…have reported that the A Body Shape Index (ABSI), rather than BMI, correlates with surgical complications in patients with gastric cancer. Further studies are required to elucidate the clinical significance of ABSI; the results might help determine the effect of abdominal obesity on gastric cancer surgery outcome and the clinical usefulness of this index 67. Enhanced BMI is a predictor of increased postoperative complications, including anastomotic leak, but it is not a predictor of survival in gastric cancer.…”

Section: Resultsmentioning

confidence: 99%

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Shimada

Fukagawa

Haga

et al. 2017

Annals of Gastroent Surgery

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PurposeThe impact of postoperative complications on survival after radical surgery for esophageal, gastric, and colorectal cancers remains controversial. We conducted a systematic review of recent publications to examine the effect of postoperative complications on oncological outcome.MethodsA literature search of PubMed/MEDLINE was performed using the keywords “esophageal cancer,” “gastric cancer,” and “colorectal cancer,” obtaining 27 reports published online up until the end of April 2016. Articles focusing on (i) postoperative morbidity and oncological outcome; and (ii) body mass index (BMI), postoperative morbidity, and oncological outcome, were selected. Univariate and multivariate analyses (Cox proportional hazards model) were performed.ResultsPatients with postoperative complications had significantly poorer long‐term survival than those without complications. Complications were associated with impaired oncological outcomes. The hazard ratios for overall survival were 1.67 (95% confidence interval [CI], 1.31‐2.12), 1.59 (95% CI, 1.13‐2.24), and 1.55 (95% CI, 1.28‐1.87) in esophageal, gastric, and colorectal cancers, respectively. High BMI was associated with postoperative morbidity rate but not with poor oncological outcome. Low BMI was significantly associated with inferior oncological outcome.ConclusionsComplications after radical surgery for esophageal, gastric, and colorectal cancers are associated with patient prognosis. Avoiding such complications might improve the outcomes.

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Section: Resultsmentioning

confidence: 99%

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Shimada

Fukagawa

Haga

et al. 2017

Annals of Gastroent Surgery

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“…Many studies have examined the relationship between BMI and prognosis in gastric cancer patients [5][6][7][8][9]. However, the prognostic significance for gastric cancer patients of being underweight remains unknown.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, overweight status and obesity have been demonstrated to be associated with a worse prognosis, partly the result of a significantly lower number of retrieved lymph nodes [5]. In contrast, some studies have reported no associations between BMI and survival [6,7], although others have documented that being overweight or obese correlates with improved survival [8,9]. These studies focused primarily on the prognostic value of being overweight or obese.…”

Section: Introductionmentioning

confidence: 99%

Impact of being underweight on the long-term outcomes of patients with gastric cancer

et al. 2015

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Background The aim of this study was to investigate the impact of being underweight on the long-term outcomes of gastric cancer patients. Methods This study reviewed the medical records of 638 patients with gastric cancer who underwent gastrectomy between January 2003 and December 2011. The patients were divided into three groups according to the WHO classification: underweight (BMI \18.5 kg/m 2 ), normal weight (BMI C18.5 and\25 kg/m 2 ), and overweight (BMI C25 kg/m 2 ). A multivariate analysis was performed to identify prognostic factors. Results The mean BMI immediately before surgery was 22.5 kg/m 2 (standard deviation, 3.3 kg/m 2 ). According to the BMI subgroup, 73 patients (11.4 %) were underweight, 431 patients (67.6 %) were of normal weight, and 134 patients (21 %) were overweight. The 5-year overall survival (OS) rate was 66.6 % in the underweight patients, 81.3 % in the normal weight patients, and 79.9 % in the overweight patients (P = 0.001). The OS rate was significantly lower in the underweight patients than in the normal weight and overweight patients among those with stage I disease, and it was also lower than in the normal weight patients among those with stage II and III disease. In the multivariate analysis, being underweight was found to be an independent predictor of OS, but it was not an independent predictor among patients with stage II and III disease.Conclusions Being underweight is a simple and reliable predictor of a worse long-term outcome among gastric cancer patients. Being underweight is considered to be associated with a higher risk of non-cancer death.

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“…In a series of 118 laparoscopic total gastrectomies, male gender was independently associated with postoperative morbidity [15] . Overweight patients [i.e., body mass index (BMI) > 25 kg/m 2 ] are at an increased risk of complications; this was shown in a large prospective series of 1853 patients [16] . This showed increased complication rate (47.9% vs 35.8%, P < 0.001).…”

Section: Surgical Risk Assessmentmentioning

confidence: 97%

Improving the outcomes in gastric cancer surgery

Tegels¹,

Maat²,

Hulsewé³

et al. 2014

WJG

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Impact of Obesity on Perioperative Complications and Long-term Survival of Patients with Gastric Cancer

Abstract: Increased BMI is a predictor of increased postoperative complications, including anastomotic leak, but it is not a predictor of survival in gastric cancer.

Cited by 108 publications

References 34 publications

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Does postoperative morbidity worsen the oncological outcome after radical surgery for gastrointestinal cancers? A systematic review of the literature

Impact of being underweight on the long-term outcomes of patients with gastric cancer

Improving the outcomes in gastric cancer surgery

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