The impact of body mass index on complication and survival in resected oesophageal cancer: a clinical-based cohort and meta-analysis

Zhang, S. S.; Yang, Hong; Luo, Kongjia; Huang, Qingyuan; Chen, J. Y.; Fu, Yang; Cai, Xiao Li; Xie, Xiaoming; Liu, Q. W.; Bella, Amos Éla; Hu, Rong; Wen, Jing; Hu, Yonghong; Fu, Jianhua

doi:10.1038/bjc.2013.666

Cited by 127 publications

(143 citation statements)

References 35 publications

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“…Multivariate analyses carried out in various studies have shown that preoperative BMI is an independent prognostic factor for reduced survival, and that it is strongly associated with postoperative complications in esophageal cancer 59. Wang et al 60.…”

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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“…Previous studies have identified several independent prognostic factors that are associated with postoperative complications and survival in patients who underwent two- to three-field LN dissection for locally advanced esophageal cancer [14,15,16,17,18]. However, each of these factors was identified from data on retrospective cohorts, and no prognostic index has been proposed on the basis of clinical trials.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Factors in Patients Receiving Neoadjuvant 5-Fluorouracil plus Cisplatin for Advanced Esophageal Cancer (JCOG9907)

Yokota

Ando

Igaki³

et al. 2015

Oncology

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Objective: Neoadjuvant chemotherapy with 5-fluorouracil plus cisplatin and subsequent esophagectomy with two- to three-field lymphadenectomy is a standard treatment for patients with clinical stage II/III squamous cell carcinoma (SCC) of the esophagus. This study investigates the prognostic factors for patients who received neoadjuvant chemotherapy. Methods: Of 164 patients assigned to receive neoadjuvant chemotherapy in the JCOG9907 trial, multivariate analyses were performed for 159 and 149 patients to evaluate the preoperative and the combined preoperative and postoperative prognostic factors, respectively. Results: The multivariate analyses using preoperative factors showed that clinical stage T3 [vs. cT1-2; hazard ratio (HR) 3.60, p = 0.0007] and serum albumin (Alb) <4.0 g/dl (vs. ≥4.0 g/dl; HR 2.29, p = 0.0005) were associated with a poor prognosis. Four independent prognostic factors were identified by multivariate analysis of both preoperative and postoperative factors: pathological curability B (pB; R0 with stage IV or pD < pN) or pC [microscopic or macroscopic residual tumor (R1/R2)] [vs. pA (R0); HR 1.93, p = 0.015], pathological stage N1 (vs. pN0; HR 3.86, p = 0.0012), cT3 (vs. cT1-2; HR 2.80, p = 0.0073), and serum Alb <4.0 g/dl (vs. ≥4.0 g/dl; HR 2.03, p = 0.0069). Conclusions: Preoperative cT stage, Alb, and postoperative pathological findings are independent prognostic factors for patients undergoing neoadjuvant chemotherapy for advanced thoracic esophageal SCC. This analysis may aid in stratification according to individual patient risk.

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“…For squamous cell carcinomas at other sites, this role seems to be different. In esophageal cancer BMI is an independent favorable predictor of survival [18]. Head and neck squamous cell carcinoma studies also showed that high BMI was associated with lower risk of mortality [19] or at least for smokers [20].…”

Section: Discussionmentioning

confidence: 99%

Penile Cancer Stage, Survival and Body Mass Index

Djajadiningrat¹,

Werkhoven²,

Horenblas³

2015

Urol Int

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Objective: The aim of this study was to determine whether a higher body mass index (BMI) in penile cancer patients is associated with more advanced penile cancer stage at the time of treatment and cancer survival. Methods: We evaluated 433 penile cancer patients treated between 2006 and 2012 at our institute and recorded American Joint Committee on Cancer (AJCC) stage, BMI, circumcision, smoking and age. A proportional odds model was used to assess a possible association between BMI and AJCC stage at diagnosis and controlled for circumcision, smoking and age. Five-year disease-specific survival was calculated using the Kaplan-Meier method, with the log-rank test assessing equality of distributions. Results: 433 patients with a mean BMI of 26.8 kg/m² were analyzed. No statistically significant association between BMI and AJCC stage was found (odds ratio 1.01 per 1 kg/m² increase in BMI, 95% confidence interval 0.97-1.05, p = 0.63). Differences in disease-specific survival were not observed based on the different BMI classes. Conclusions: No association between BMI of penile cancer patients and their disease stage at the time of treatment was observed. Thus, BMI at penile cancer treatment does not affect prognosis.

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The impact of body mass index on complication and survival in resected oesophageal cancer: a clinical-based cohort and meta-analysis

Cited by 127 publications

References 35 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

Prognostic Factors in Patients Receiving Neoadjuvant 5-Fluorouracil plus Cisplatin for Advanced Esophageal Cancer (JCOG9907)

Penile Cancer Stage, Survival and Body Mass Index

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