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01-02-2007

Influence of Overweight on Surgical Complications for Gastric Cancer: Results From a Randomized Control Trial Comparing D2 and Extended Para-aortic D3 Lymphadenectomy (JCOG9501)

Authors: Toshimasa Tsujinaka, MD, Mitsuru Sasako, MD, Seiichiro Yamamoto, PhD, Takeshi Sano, MD, Yukinori Kurokawa, MD, Atsushi Nashimoto, MD, Akira Kurita, MD, Hitoshi Katai, MD, Toshio Shimizu, MD, Hiroshi Furukawa, MD, Satoru Inoue, MD, Masahiro Hiratsuka, MD, Taira Kinoshita, MD, Kuniyoshi Arai, MD, Yoshitaka Yamamura, MD

Published in: Annals of Surgical Oncology | Issue 2/2007

Abstract

Background

The impact of overweight on the outcome of gastrectomy with lymphadenectomy is controversial, and data from a well-controlled, randomized study are needed to identify a possible relationship.

Methods

We used data from 523 patients registered for a prospective randomized trial comparing D2 and extended para-aortic D3 lymphadenectomy to compare the effects of body mass index (BMI) and the extent of lymphadenectomy for the development of general or major surgical complications (anastomotic leakage, abdominal abscess, and pancreatic fistula).

Results

Seventy-seven patients were classified as overweight with BMI ≥ 25, and 38 and 39 of these patients underwent a D2 or D3 lymphadenectomy, respectively. Among the 446 patients classified as nonoverweight with BMI < 25, 225 received D2 and 221 received D3 lymphadenectomy. Surgical complications, operation time, and blood loss were statistically significantly associated with BMI, and logistic regression analysis revealed that overweight directly affected the occurrence of surgical complications even after considering operation time and blood loss as intermediate factors instead of outcome variables. Among patients undergoing D2 lymphadenectomy, being overweight increased the risk for surgical complications and blood loss, whereas overweight was associated with only blood loss and operation time among patients receiving D3 lymphadenectomy.

Conclusions

Overweight increased the risk of surgical complications in patients undergoing gastrectomy both directly and indirectly through operation time and blood loss. The impact of overweight on surgical complications was more evident in patients undergoing a D2 dissection.

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Title: Influence of Overweight on Surgical Complications for Gastric Cancer: Results From a Randomized Control Trial Comparing D2 and Extended Para-aortic D3 Lymphadenectomy (JCOG9501)
Authors: Toshimasa Tsujinaka, MD
Mitsuru Sasako, MD
Seiichiro Yamamoto, PhD
Takeshi Sano, MD
Yukinori Kurokawa, MD
Atsushi Nashimoto, MD
Akira Kurita, MD
Hitoshi Katai, MD
Toshio Shimizu, MD
Hiroshi Furukawa, MD
Satoru Inoue, MD
Masahiro Hiratsuka, MD
Taira Kinoshita, MD
Kuniyoshi Arai, MD
Yoshitaka Yamamura, MD
Publication date: 01-02-2007
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 2/2007
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-006-9209-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Influence of Overweight on Surgical Complications for Gastric Cancer: Results From a Randomized Control Trial Comparing D2 and Extended Para-aortic D3 Lymphadenectomy (JCOG9501)

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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