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KMID : 1141820180180030274
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Journal of Gastric Cancer
2018 Volume.18 No. 3 p.274 ~ p.286
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The Impact of Preoperative Low Body Mass Index on Postoperative Complications and Long-term Survival Outcomes in Gastric Cancer Patients
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Kim Chang-Hyun
Park Seung-Man
Kim Jin-Jo
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Abstract
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Purpose: The aim of this study was to investigate the impact of preoperative low body mass index (BMI) on both the short- and long-term outcomes in patients with gastric cancer.
Materials and Methods: A total of 510 patients with gastric cancer were divided into the following 3 groups: low BMI group (≤18.5 kg/m2, n=51), normal BMI group (18.6?24.9 kg/m2, n=308), and high BMI group (≥25.0 kg/m2, n=151).
Results: There were significantly more stage III/IV patients in the low BMI group than in the other groups (P=0.001). Severe postoperative complications were more frequent (P=0.010) and the survival was worse (P<0.001) in the low BMI group. The subgroup analysis indicated that survival was worse in the low BMI group of the stage I/II subgroup (P=0.008). The severe postoperative complication rate was higher in the low BMI group of the stage III/IV subgroup (P=0.001), although the recurrence rate and survival did not differ in the stage III/IV subgroup among all the BMI groups. Low BMI was an independent poor prognostic factor in the stage I/II subgroup (disease-free survival: hazard ratio [HR], 13.521; 95% confidence interval [CI], 1.186?154.197; P=0.036 and overall survival: HR, 5.130; 95% CI, 1.644?16.010; P=0.005), whereas low BMI was an independent risk factor for severe postoperative complications in the stage III/IV subgroup (HR, 17.158; 95% CI, 1.383?212.940; P=0.027).
Conclusions: Preoperative low BMI in patients with gastric cancer adversely affects survival among those with stage I/II disease and increases the severe postoperative complication rate among those with stage III/IV disease.
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KEYWORD
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Stomach neoplasms, Body mass index, Obesity, Underweight
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