Influence of Overweight on Patients With Gastric Cancer After Undergoing Curative Gastrectomy

Ojima, Toshiyasu; Itō, Makoto; Nakamori, Mikihito; Nakamura, Masaki; Naka, Teiji; Ishida, Koichiro; Ueda, Kentaro; Katsuda, Masahiro; Iida, Takeshi; Tsuji, Toshiaki; Yamaue, Hiroki

doi:10.1001/archsurg.2009.20

Cited by 77 publications

(61 citation statements)

References 41 publications

(21 reference statements)

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“…8,10,12,21 Similarly, the definitive implications of overweight in Western patients with gastric cancer have yet to be determined due to the paucity of data for the association between BMI and prognosis. 22 Using a well defined multi-institutional data set from a Western country, the present study demonstrated that overweight was associated with a significant survival benefit by univariate analysis.…”

Section: Discussionmentioning

confidence: 99%

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

Kulig

Sierżęga

Kołodziejczyk

et al. 2010

European Journal of Surgical Oncology (EJSO)

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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 diseasespecific survival of overweight patients was significantly higher (36.7 months, 95%confidence interval (CI) 29.0 to 44.4) than those with BMI<25 kg/m 2 (25.7 months, 95%CI23.2 to 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.

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Section: Discussionmentioning

confidence: 99%

“…3,4 Several authors have already reported that overweight increases the incidence of general and intra-abdominal complications in Asian patients undergoing gastrectomy for gastric cancer. [5][6][7][8][9][10][11][12] Some recent studies also suggested that obesity may correlate with long-term prognosis.…”

Section: Introductionmentioning

confidence: 99%

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

Kulig

Sierżęga

Kołodziejczyk

et al. 2010

European Journal of Surgical Oncology (EJSO)

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“…In general, patients with gastric cancer tend to be cachexic with low BMIs as gastric cancer progresses to more advanced stages because such patients tend to have gastrointestinal symptoms such as epigastric pain, nausea, and anorexia, particularly in gastric outlet obstruction. Previous studies have shown significant decreased prevalence of T3-4 or N2-3 category cancer in patients with BMI C 25 kg/m 2 , although some studies have provided no relationship between BMI and the stage of gastric cancers [48,49]. Previous studies suggesting a relationship between obesity and gastric cancers have generally ignored weight change from tumor progression and enrolled patients without considering the stage of their tumor.…”

Section: Discussionmentioning

confidence: 99%

Relationship between body mass index and the risk of early gastric cancer and dysplasia regardless of Helicobacter pylori infection

Kim

et al. 2014

Gastric Cancer

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AbstractsBackground Obesity is known to be associated with an increased risk of gastric cardia cancer but not with noncardia cancer. In terms of gastric dysplasia, few studies have evaluated its relationship with obesity. In addition, no study on the relationship between obesity and the risk of gastric cancer has analyzed the status of Helicobacter pylori infection. Methods A case-control study was designed to investigate the relationship between obesity and the risk of gastric cancer and dysplasia adjusted for the status of H. pylori infection in Koreans. Nine hundred ninety-eight gastric cancer patients, 313 gastric dysplasia patients, and 1,288 subjects with normal endoscopic findings were included. Results As gender differences could be the largest confounding factor, the risk of gastric cancer and dysplasia with an increasing body mass index (BMI) was analyzed in men and women, separately, and was adjusted for age, smoking, drinking, family history of gastric cancer, H. pylori infection, atrophic gastritis, intestinal metaplasia, and serum pepsinogen I/pepsinogen II ratio. Obesity (BMI 25 kg/m 2 or greater but less than 30 kg/m 2 ) was associated with increased risk of early gastric cancer [adjusted odds ratio (aOR) 1.657; 95 % confidence interval (CI) 1.086-2.528; P = 0.019] and well or moderately differentiated adenocarcinoma (aOR 1.566; 95 % CI 1.011-2.424; P = 0.044) compared with normal BMI status (BMI \ 23 kg/m 2 ) in men. Obesity was related to gastric dysplasia (aOR 2.086; 95 % CI 1.011-4.302; P = 0.047) in women. Conclusions The effect of obesity on gastric cancer showed a gender difference. That is, in men it was related to increased risk of early gastric cancer and well or moderately differentiated adenocarcinoma, but it was associated with gastric dysplasia in women regardless of H. pylori infection in Korea. Further research into this difference is necessary.

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“…There are some reasons behind our figures converging toward that level. One is the comparatively high rate of multivisceral resections and another may be a high median BMI (25.2); this has been defined as a risk factor for anastomotic leakage in gastric surgery [29,30]. Based on current clinical evidence it is difficult to define a causal relationship between POPF and anastomotic complications when the procedures do not involve the pancreatic gland per se.…”

Section: Discussionmentioning

confidence: 99%

Postoperative pancreatic fistula formation according to ISGPF criteria after D2 gastrectomy in Western patients

et al. 2013

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Background Limited information is available on the incidence of postoperative pancreatic fistula (POPF) after D2 gastrectomy with the strict use of the International Study Group of Pancreatic Fistula (ISGPF) criteria, particularly so in Western patients. Methods All patients who underwent gastrectomy for adenocarcinoma at the Karolinska University Hospital Huddinge from 2006 until June 2012 were identified via hospital records and reviewed for type of surgical procedure, postoperative morbidity, incidence, and risk factors for POPF. Results Ninety-two of 107 cases had a D2 gastrectomy eligible for evaluation of POPF, of which 83 (90 %) also underwent bursectomy. Seven patients fulfilled the criteria for POPF grade A (7.6 %), 5 met the criteria for POPF grade B (5.4 %), and 6 the criteria for POPF grade C (6.5 %). The incidence of POPF grade B or C was 4.9 % among the 82 patients for whom no pancreatic resection was performed and 70 % among 10 cases with concomitant pancreatic resection. The latter (OR 156.2, 95 % CI 8.00-3046.93) and age (OR 1.2, 95 % CI 1.02-1.35) were found to be the only risk factors for POPF after gastrectomy upon a multivariate analysis.Conclusions In this series of Western patients, POPF grade B or C according to the ISGPF criteria was uncommon after D2 gastrectomy without pancreatic resection. Bursectomy was not a risk factor for POPF.

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Influence of Overweight on Patients With Gastric Cancer After Undergoing Curative Gastrectomy

Abstract: Being overweight is not a poor risk factor for survival in patients with gastric cancer, although it is independently predictive of postoperative complications.

Cited by 77 publications

References 41 publications

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

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

Relationship between body mass index and the risk of early gastric cancer and dysplasia regardless of Helicobacter pylori infection

Postoperative pancreatic fistula formation according to ISGPF criteria after D2 gastrectomy in Western patients

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