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01-03-2013 | Gastrointestinal Oncology

Impact of Obesity on Perioperative Complications and Long-term Survival of Patients with Gastric Cancer

Authors: Kai A. Bickenbach, MD, Brian Denton, MS, Mithat Gonen, PhD, Murray F. Brennan, MD, Daniel G. Coit, MD, Vivian E. Strong, MD

Published in: Annals of Surgical Oncology | Issue 3/2013

Abstract

Background

The prevalence of obesity is increasing in the United States. Obesity has been associated with worse surgical outcomes, but its impact on long-term outcomes in gastric cancer is unclear. The aim of this study was to evaluate the effects of being overweight on surgical and long-term outcomes for patients with gastric cancer.

Methods

Patients who underwent curative intent resection for gastric carcinoma from 1985 to 2007 were identified from a prospectively collected gastric cancer database. Overweight was defined as a body mass index (BMI) of 25 kg/m² or higher. Clinical outcomes of overweight and nonoverweight patients were compared.

Results

From the total population of 1,853 patients, 1,125 (60.7 %) were overweight. Overweight patients tended to have more proximal tumors and a lower T stage. Accurate complication data were available on a subset of patients from 2000 to 2007. A BMI of ≥25 was associated with increased postoperative complications (47.9 vs. 35.8 %, p < 0.001). This was mainly due to an increase in the rate of wound infections (8.9 vs. 4.7 %, p = 0.02) and anastomotic leaks (11.8 vs. 5.4 %, p = 0.002). Multivariate logistic regression analysis showed that higher BMI, total gastrectomy, and use of neoadjuvant chemotherapy were associated with increased wound infection and anastomotic leak. Overweight patients were less likely to have adequate lymph node staging (73.3 vs. 79.2 %, p = 0.047). There was no difference in overall survival or disease-specific survival between the two groups.

Conclusions

Increased BMI is a predictor of increased postoperative complications, including anastomotic leak, but it is not a predictor of survival in gastric cancer.

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Title: Impact of Obesity on Perioperative Complications and Long-term Survival of Patients with Gastric Cancer
Authors: Kai A. Bickenbach, MD
Brian Denton, MS
Mithat Gonen, PhD
Murray F. Brennan, MD
Daniel G. Coit, MD
Vivian E. Strong, MD
Publication date: 01-03-2013
Publisher: Springer-Verlag
Published in: Annals of Surgical Oncology / Issue 3/2013
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-012-2653-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Impact of Obesity on Perioperative Complications and Long-term Survival of Patients with Gastric Cancer

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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