Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, 201 Section 2 Shih-Pai Road, Taipei, 11217, Taiwan.
J Gastrointest Surg. 2013 Aug;17(8):1382-91. doi: 10.1007/s11605-013-2238-x. Epub 2013 May 29.
The impact of body mass index (BMI) on the outcome of advanced gastric cancer surgery is controversial. Between December 1987 and December 2006, a total of 947 advanced gastric cancer patients receiving curative resection with retrieved lymph node number >15 were studied and divided into three groups according to BMI (<25, 25-30, and >30 kg/m(2)).
With regard to comorbidities present prior to surgery, higher BMI patients were more likely to have heart disease, type 2 diabetes, and hypertension than lower BMI patients. Compared with BMI <25 kg/m(2), higher BMI patients had longer operative time and more surgery-related morbidity. Multivariate Cox proportional-hazard analysis showed that age, pathological T and N categories, and lymphovascular invasion were independent prognostic factors. The initial recurrence patterns, 5-year overall survival, and cancer-specific survival were similar among the three groups.
Only in stage III gastric cancer with BMI less than 25 kg/m(2) patients receiving total gastrectomy had a more advanced pathological N category and a worse prognosis compared to those receiving subtotal gastrectomy. Higher BMI was associated with longer operative time and more surgery-related morbidity than lower BMI. BMI alone is not an independent prognostic factor.
体质量指数（BMI）对进展期胃癌手术结果的影响存在争议。1987 年 12 月至 2006 年 12 月，共对 947 例接受根治性切除术且淋巴结检出数>15 枚的进展期胃癌患者进行了研究，并根据 BMI（<25、25-30 和>30 kg/m²）将其分为三组。
就术前并存疾病而言，BMI 较高的患者发生心脏病、2 型糖尿病和高血压的可能性高于 BMI 较低的患者。与 BMI<25 kg/m²相比，BMI 较高的患者手术时间更长，手术相关发病率更高。多变量 Cox 比例风险分析表明，年龄、病理 T 和 N 分期以及脉管侵犯是独立的预后因素。三组患者的初始复发模式、5 年总生存率和癌症特异性生存率相似。
仅在 BMI<25 kg/m²的 III 期胃癌患者中，全胃切除术比次全胃切除术具有更晚期的病理 N 分期和更差的预后。与 BMI 较低的患者相比，BMI 较高的患者手术时间更长，手术相关发病率更高。BMI 本身不是独立的预后因素。
