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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 12/2009

01-12-2009 | Gastrointestinal Oncology

Better 5-Year Survival Rate Following Curative Gastrectomy in Overweight Patients

Authors: Masanori Tokunaga, MD, Naoki Hiki, MD, PhD, Tetsu Fukunaga, MD, PhD, Shigekazu Ohyama, MD, PhD, Toshiharu Yamaguchi, MD, PhD, Toshifusa Nakajima, MD, PhD

Published in: Annals of Surgical Oncology | Issue 12/2009

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Abstract

Background

Westernization of lifestyle and diet has resulted in an increase in overweight patients in Japan. Although the adverse effects of higher body mass index (BMI) on early surgical outcomes are known, the relationship between BMI and long-term outcome is unclear.

Materials and Methods

Clinicopathological characteristics and 5-year survival rate of overweight (BMI ≥25 kg/m2; H-BMI; n = 1126) and nonoverweight (BMI <25 kg/m2; N-BMI; n = 6799) patients who underwent gastrectomy with curative intent at the Cancer Institute Hospital between 1970 and 2004 were compared.

Results

Patients in the H-BMI group tended to have earlier-stage disease. The 5-year survival rate was significantly better in the H-BMI than N-BMI group (81.5% vs 74.1%, respectively; P < .001). Postoperative mortality was 1% in both groups (P = .482), whereas postoperative morbidity was 22% and 19% in the H-BMI and N-BMI groups, respectively (P = .007). Multivariate analysis indicated overweight, age, gender, surgical procedure, histology, operation year, pT, and pN as independent prognostic factors. Subset analyses of pT and pN stages revealed overweight as an independent prognostic factor in patients with pT1 and pN0.

Conclusion

The 5-year survival rate following curative gastrectomy is better in overweight than nonoverweight Japanese patients, especially for early-stage gastric cancer. Further studies are needed to determine whether these results apply to other countries where morbidity and mortality for gastric cancer are higher than in Asian countries.
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Metadata
Title
Better 5-Year Survival Rate Following Curative Gastrectomy in Overweight Patients
Authors
Masanori Tokunaga, MD
Naoki Hiki, MD, PhD
Tetsu Fukunaga, MD, PhD
Shigekazu Ohyama, MD, PhD
Toshiharu Yamaguchi, MD, PhD
Toshifusa Nakajima, MD, PhD
Publication date
01-12-2009
Publisher
Springer-Verlag
Published in
Annals of Surgical Oncology / Issue 12/2009
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-009-0645-8

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