Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Department of Radiation Oncology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Radiation Oncology, The Fifth Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
Can J Gastroenterol Hepatol. 2018 Jan 28;2018:6075207. doi: 10.1155/2018/6075207. eCollection 2018.
The prognostic values of weight loss and body mass index (BMI) in esophageal carcinoma remain controversial. This study aimed to evaluate the impacts of weight loss on the survival of patients undergoing radical surgery and adjuvant chemotherapy.
The medical records of 189 consecutive patients with nonmetastatic esophageal carcinoma treated in our hospital between January 2012 and December 2013 were reviewed, and 121 patients were included for analysis.
Kaplan-Meier analysis revealed that the 3-year overall survival rate was significantly higher in the low pretreatment weight loss (pre-LWL) group than in the high pretreatment weight loss (pre-HWL) group ( < 0.001). In addition, the 3-year overall survival rate of normal weight group was higher than that of overweight and underweight groups ( = 0.007). Multivariate Cox proportional hazards analysis showed that pre-LWL group had a significantly better 3-year overall survival than pre-HWL group ( = 0.027, HR = 1.89, and 95% CI = 1.07-3.32). pN stage and age were also the survival prognostic factors.
Our study showed that low pretreatment weight loss predicted a better survival outcome in the esophageal carcinoma patients with radical surgery and adjuvant chemotherapy. However, BMI and weight loss during treatment had no impact on the survival outcome.
体重减轻和体重指数（BMI）在食管癌中的预后价值仍存在争议。本研究旨在评估体重减轻对接受根治性手术和辅助化疗的食管癌患者生存的影响。
回顾性分析 2012 年 1 月至 2013 年 12 月我院收治的 189 例非转移性食管癌患者的病历资料，其中 121 例患者纳入分析。
Kaplan-Meier 分析显示，低术前体重减轻（pre-LWL）组的 3 年总生存率明显高于高术前体重减轻（pre-HWL）组（<0.001）。此外，正常体重组的 3 年总生存率高于超重和体重不足组（=0.007）。多因素 Cox 比例风险分析显示，pre-LWL 组的 3 年总生存率明显优于 pre-HWL 组（=0.027，HR=1.89，95%CI=1.07-3.32）。pN 分期和年龄也是生存的预后因素。
本研究表明，根治性手术和辅助化疗的食管癌患者术前体重减轻程度较低，预示着更好的生存结局。然而，BMI 和治疗期间的体重减轻对生存结局没有影响。
