胃癌患者胃切除术后体重指数对生存的影响。

Survival impact of postoperative body mass index in gastric cancer patients undergoing gastrectomy.

作者信息

Lee Han Hee, Park Jae Myung, Song Kyo Young, Choi Myung-Gyu, Park Cho Hyun

机构信息

Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.

出版信息

Eur J Cancer. 2016 Jan;52:129-37. doi: 10.1016/j.ejca.2015.10.061. Epub 2015 Dec 10.

DOI:10.1016/j.ejca.2015.10.061

PMID:26686912

Abstract

BACKGROUND

The relationship between preoperative body mass index (BMI) and the survival of postoperative gastric cancer patients is not clear. Furthermore, the survival impact with postoperative BMI is not known, even though weight loss is inevitable after gastrectomy.

METHODS

Patients who underwent gastrectomy for gastric cancer between 2000 and 2008 were included in the study (n = 1909). Patients were divided into three groups based on their BMIs: low (<18.5 kg/m(2)), normal (18.5-24.9 kg/m(2)), and high BMI (≥ 25.0 kg/m(2)). Patient survival was compared according to BMI at two time points: baseline and 1 year after surgery.

RESULTS

Regarding BMI 1 year after surgery, overall survival, disease-specific survival, and recurrence-free survival were longer in the high BMI group than the low and normal BMI groups. In a Cox proportional hazards model, adjusting for the patient's age, sex, type of surgery, tumour stage, histology, curative resection, and BMI at baseline, a high BMI 1 year after surgery was associated with lower overall mortality compared to normal BMI (hazard ratio 0.51; 95% confidence interval, 0.26-0.98). However, BMI at baseline was not an independent prognostic factor.

CONCLUSION

BMI 1 year after surgery significantly predicted the long-term survival of patients with gastric cancer compared with the preoperative BMI.

摘要

背景

术前体重指数（BMI）与胃癌患者术后生存率之间的关系尚不清楚。此外，尽管胃切除术后体重减轻不可避免，但术后BMI对生存率的影响尚不清楚。

方法

本研究纳入了2000年至2008年间接受胃癌胃切除术的患者（n = 1909）。根据BMI将患者分为三组：低BMI组（<18.5 kg/m²）、正常BMI组（18.5 - 24.9 kg/m²）和高BMI组（≥25.0 kg/m²）。在两个时间点根据BMI比较患者生存率：基线和术后1年。

结果

关于术后1年的BMI，高BMI组患者的总生存期、疾病特异性生存期和无复发生存期均长于低BMI组和正常BMI组。在Cox比例风险模型中，在对患者的年龄、性别、手术类型、肿瘤分期、组织学、根治性切除和基线BMI进行校正后，与正常BMI相比，术后1年高BMI与较低的总死亡率相关（风险比0.51；95%置信区间，0.26 - 0.98）。然而，基线BMI不是一个独立的预后因素。