Department of Gastrointestinal Surgery, Japanese Red Cross Nagoya First Hospital, 3-35 Michishita-cho, Nakamura-ku, Nagoya, 453-8511, Japan.
World J Surg. 2019 Jul;43(7):1766-1776. doi: 10.1007/s00268-019-04969-1.
Obesity has been reported to be a prognostic factor for many diseases in epidemiological studies; however, the results of studies examining the relationship between obesity and gastric cancer (GC) prognosis are inconsistent.
A total of 460 patients with Stage II and III GC who underwent open R0 gastrectomy were included. Age, sex, body mass index (BMI classified into < 18.5, 18.5-25, and ≥ 25 kg/m), stage, and postoperative adjuvant chemotherapy were analyzed to investigate the correlation with relapse-free survival (RFS).
Five-year RFS was 51% for the study patients. Five-year RFS values were 47.6%, 54.3%, and 40.1% for patients with BMI < 18.5, 18.5-25, and ≥ 25 kg/m, respectively. The forest plot for relapse risk according to BMI showed a U shape. Multivariate analysis for RFS showed significant differences in stage and BMI; the hazard ratio for recurrence in patients with BMI ≥ 25 kg/m was 1.42 (95% confidence interval: 1.01-2.02, p = 0.0423) with reference to patients with BMI < 25 kg/m. BMI ≥ 25.0 was associated with longer operation times, more blood loss, fewer lymph nodes dissected, more frequent postoperative surgical site infection, and intra-abdominal abscesses.
BMI ≥ 25 kg/m is an unfavorable prognostic factor for patients who underwent gastrectomy for Stage II and III GC.
肥胖症在流行病学研究中被报道为许多疾病的预后因素；然而，研究肥胖症与胃癌（GC）预后之间关系的结果并不一致。
共纳入 460 名接受开放式 R0 胃切除术的 II 期和 III 期 GC 患者。分析年龄、性别、体重指数（BMI 分为<18.5、18.5-25 和≥25kg/m）、分期和术后辅助化疗与无复发生存（RFS）的相关性。
研究患者的 5 年 RFS 为 51%。BMI<18.5、18.5-25 和≥25kg/m 的患者 5 年 RFS 值分别为 47.6%、54.3%和 40.1%。根据 BMI 的复发风险森林图呈 U 形。RFS 的多变量分析显示分期和 BMI 有显著差异；BMI≥25kg/m 的患者复发风险比为 1.42（95%置信区间：1.01-2.02，p=0.0423），与 BMI<25kg/m 的患者相比。BMI≥25.0 与手术时间较长、出血量较多、淋巴结清扫较少、术后手术部位感染和腹腔脓肿更频繁有关。
BMI≥25kg/m 是接受 II 期和 III 期 GC 胃切除术患者的不利预后因素。
