Duan Xiao-Feng, Tang Peng, Shang Xiao-Bin, Jiang Hong-Jing, Zhao Qiang, Yu Zhen-Tao
Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
Dig Surg. 2017;34(4):319-327. doi: 10.1159/000453044. Epub 2017 Jan 19.
To investigate the prognostic significance of body mass index (BMI) on the survival of patients with esophageal squamous cell carcinoma (ESCC) after esophagectomy.
Between 2005 and 2008, 291 patients with ESCC who met the inclusion criteria were included in the study. The BMI cut-off values were as follows: 18.5-23 kg/m2 for normal weight; 23-27.5 kg/m2 for overweight; and ≥27.5 kg/m2 for those with obesity. Univariate and multivariate analyses were performed to identify prognostic factors for long-term survival.
Patients were divided into 3 groups: normal weight (n = 138), overweight (n = 103), and obese (n = 50). The median survival time was 56 months. The 5-year overall survival (OS) rates were 40.8, 44.7, and 20.8% for normal weight, overweight, and obese patients respectively (p < 0.05). Multivariate analysis identified BMI as an independent prognostic factor for OS (p < 0.05). For 179 patients without lymph node metastasis, the 5-year OS rates were 46.5, 50.7, and 27.0% for normal weight, overweight, and obese patients respectively (p < 0.05).
A BMI ≥27.5 kg/m2 has a distinctly adverse impact on the long-term survival of ESCC patients after esophagectomy. High BMI is a potential predictor of worse prognosis in ESCC patients, particularly in patients without lymph node metastasis.
探讨体重指数（BMI）对食管鳞状细胞癌（ESCC）患者食管切除术后生存的预后意义。
2005年至2008年期间，291例符合纳入标准的ESCC患者纳入本研究。BMI的临界值如下：体重正常为18.5 - 23kg/m²；超重为23 - 27.5kg/m²；肥胖为≥27.5kg/m²。进行单因素和多因素分析以确定长期生存的预后因素。
患者分为3组：体重正常组（n = 138）、超重组（n = 103）和肥胖组（n = 50）。中位生存时间为56个月。体重正常、超重和肥胖患者的5年总生存率（OS）分别为40.8%、44.7%和20.8%（p < 0.05）。多因素分析确定BMI是OS的独立预后因素（p < 0.05）。对于179例无淋巴结转移的患者，体重正常、超重和肥胖患者的5年OS率分别为46.5%、50.7%和27.0%（p < 0.05）。
BMI≥27.5kg/m²对ESCC患者食管切除术后的长期生存有明显不利影响。高BMI是ESCC患者预后较差的潜在预测因素，尤其是在无淋巴结转移的患者中。
