Impact of obesity on perioperative complications and long-term survival of patients with gastric cancer Journal Article

Authors: Bickenbach, K. A.; Denton, B.; Gonen, M.; Brennan, M. F.; Coit, D. G.; Strong, V. E.
Article Title: Impact of obesity on perioperative complications and long-term survival of patients with gastric cancer
Abstract: Background: The prevalence of obesity is increasing in the United States. Obesity has been associated with worse surgical outcomes, but its impact on long-term outcomes in gastric cancer is unclear. The aim of this study was to evaluate the effects of being overweight on surgical and long-term outcomes for patients with gastric cancer. Methods: Patients who underwent curative intent resection for gastric carcinoma from 1985 to 2007 were identified from a prospectively collected gastric cancer database. Overweight was defined as a body mass index (BMI) of 25 kg/m2 or higher. Clinical outcomes of overweight and nonoverweight patients were compared. Results: From the total population of 1,853 patients, 1,125 (60.7 %) were overweight. Overweight patients tended to have more proximal tumors and a lower T stage. Accurate complication data were available on a subset of patients from 2000 to 2007. A BMI of ≥25 was associated with increased postoperative complications (47.9 vs. 35.8 %, p < 0.001). This was mainly due to an increase in the rate of wound infections (8.9 vs. 4.7 %, p = 0.02) and anastomotic leaks (11.8 vs. 5.4 %, p = 0.002). Multivariate logistic regression analysis showed that higher BMI, total gastrectomy, and use of neoadjuvant chemotherapy were associated with increased wound infection and anastomotic leak. Overweight patients were less likely to have adequate lymph node staging (73.3 vs. 79.2 %, p = 0.047). There was no difference in overall survival or disease-specific survival between the two groups. Conclusions: Increased BMI is a predictor of increased postoperative complications, including anastomotic leak, but it is not a predictor of survival in gastric cancer. © 2012 Society of Surgical Oncology.
Journal Title: Annals of Surgical Oncology
Volume: 20
Issue: 3
ISSN: 1068-9265
Publisher: Springer  
Date Published: 2013-03-01
Start Page: 780
End Page: 787
Language: English
DOI: 10.1245/s10434-012-2653-3
PROVIDER: scopus
PUBMED: 22976377
Notes: --- - "Export Date: 1 April 2013" - "CODEN: ASONF" - "Source: Scopus"
Citation Impact
MSK Authors
  1. Brian Denton
    11 Denton
  2. Murray F Brennan
    1027 Brennan
  3. Mithat Gonen
    884 Gonen
  4. Vivian Strong
    212 Strong
  5. Daniel Coit
    508 Coit