Author: Grotenhuis B.
Publisher: Springer Publishing Company
ISSN: 0364-2313
Source: World Journal of Surgery, Vol.34, Iss.11, 2010-11, pp. : 2621-2627
Disclaimer: Any content in publications that violate the sovereignty, the constitution or regulations of the PRC is not accepted or approved by CNPIEC.
Abstract
Cachexia and obesity have been suggested to be risk factors for postoperative complications. However, high body mass index (BMI) might result in a higher R0-resection rate because of the presence of more fatty tissue surrounding the tumor. The purpose of this study was to investigate whether BMI is of prognostic value with regard to short-term and long-term outcome in patients who undergo esophagectomy for cancer. In 556 patients who underwent esophagectomy (1991–2007), clinical and pathological outcome were compared between different BMI classes (underweight, normal weight, overweight, obesity). Overall morbidity, mortality, and reoperation rate did not differ in underweight and obese patients. However, severe complications seemed to occur more often in obese patients (p = 0.06), and the risk for anastomotic leakage increased with higher BMI (12.5% in underweight patients compared with 27.6% in obese patients, p = 0.04). Histopathological assessment showed comparable pTNM stages, although an advanced pT stage was seen more often in patients with low/normal BMI (p = 0.02). A linear association between BMI and R0-resection rate was detected (p = 0.02): 60% in underweight patients compared with 81% in obese patients. However, unlike pT-stage (p < 0.001), bmi="" was="" not="" an="" independent="" predictor="" for="" r0="" resection="">p = 0.12). There was no significant difference in overall or disease-free 5-year survival between the BMI classes (p = 0.25 and p = 0.6, respectively). BMI is not of prognostic value with regard to short-term and long-term outcome in patients who undergo esophagectomy for cancer and is not an independent predictor for radical R0 resection. Patients oncologically eligible for esophagectomy should not be denied surgery on the basis of their BMI class.
Related content
By White Ian Greenberg Ron Itah Refael Inbar Roy Schneebaum Shlomo Avital Shmuel
JSLS, Journal of the Society of Laparoendoscopic Surgeons, Vol. 15, Iss. 2, 2011-04 ,pp. :
By Park Jun Lee Sang Seo Ju Kim Yu Chung Hyunsoo Shin Sung Lee Yong
Surgical Endoscopy, Vol. 24, Iss. 11, 2010-11 ,pp. :