Gastric cancer: high BMI tied to inferior RFS after gastrectomy

  • Kambara Y & al.
  • World J Surg
  • 28 Feb 2019

  • curated by David Reilly
  • Univadis Clinical Summaries
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Takeaway

  • High BMI is an unfavorable prognostic indicator for relapse-free survival (RFS) in patients undergoing R0 gastrectomy for stage II/III gastric cancer (GC).

Why this matters

  • The incidence of obesity continues to increase globally.

Study design

  • Study to investigate a relationship between BMI and outcomes in patients with stage II/III GC who underwent elective open R0 gastrectomy.
  • Mean patient age, 67.8 (range, 31-88) years.
  • Postoperative adjuvant chemotherapy was administered per Japanese gastric cancer treatment guidelines.
  • Patients were stratified by BMI:
    • 2: n=64.
    • 18.5-25 kg/m2: n=320.
    • ≥25 kg/m2: n=76.
  • Funding: None disclosed.

Key results

  • 5-year RFS by BMI:
    • 2: 47.6%.
    • 18.5-25 kg/m2: 54.3%.
    • ≥25 kg/m2: 40.1%
  • In patients with BMI ≥25.0 kg/m2 vs those with BMI 2, HR for relapse is 1.42 (95% CI, 1.0-2.02; P=.0423).
  • Inferior survival in patients with BMI >25.0 kg/m2 vs 2 (P=.076).
  • BMI >25.0 kg/m2 was associated with:
    • longer operation time (P=.0610),
    • increased blood loss (P=.0003), and
    • fewer lymph nodes dissected (P=.1894).
  • Patients with BMI >25.0 kg/m2 were more likely to experience postoperative complications, surgical site infection, and intra-abdominal abscess.

Limitations

  • Retrospective data.