Published online Mar 15, 2021. doi: 10.4251/wjgo.v13.i3.161
Peer-review started: November 22, 2020
First decision: December 17, 2020
Revised: December 31, 2020
Accepted: February 4, 2021
Article in press: February 4, 2021
Published online: March 15, 2021
The association between body mass index (BMI) and clinical outcomes remains unclear among patients with resectable gastric cancer.
To investigate the relationship between BMI and long-term survival of gastric cancer patients.
This retrospective study included 2526 patients who underwent radical gastrectomy for gastric cancer between September 2013 and June 2018. The patients were divided into four groups: Group A (low BMI, < 18.5 kg/m2), group B (normal BMI, 18.5-24.9 kg/m2), group C (overweight, 25-29.9 kg/m2), and group D (obese, ≥ 30 kg/m2). Clinicopathological findings and survival outcomes were recorded and analyzed.
Preoperative weight loss was more common in the low-BMI group, while diabetes was more common in the obese group. Upper-third gastric cancer accounted for a large proportion of cases in the higher BMI groups. Major perioperative complications tended to increase with BMI. The 5-year overall survival rates were 66.4% for group A, 75.0% for group B, 77.1% for group C, and 78.6% for group D. The 5-year overall survival rate was significantly lower in group A than in group C (P = 0.008) or group D (P = 0.031). Relative to a normal BMI value, a BMI of < 18.5 kg/m2 was associated with poor survival (hazard ratio: 1.558, 95% confidence interval: 1.125-2.158, P = 0.008).
Low BMI, but not high BMI, independently predicted poor survival in patients with resectable gastric cancer.
Core Tip: The association between body mass index (BMI) and clinical outcomes remains unclear among patients with resectable gastric cancer. The findings of this study suggest that low BMI may result in unfavorable long-term outcomes among patients with resectable gastric cancer. The factor associated with poor overall survival based on multivariate analysis was low BMI, rather than high BMI.