低体重指数是可切除胃癌患者长期预后不良的独立预测因素。
Low body mass index is an independent predictor of poor long-term prognosis among patients with resectable gastric cancer.
作者信息
Ma Shuai, Liu Hao, Ma Fu-Hai, Li Yang, Jin Peng, Hu Hai-Tao, Kang Wen-Zhe, Li Wei-Kun, Xiong Jian-Ping, Tian Yan-Tao
机构信息
Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
出版信息
World J Gastrointest Oncol. 2021 Mar 15;13(3):161-173. doi: 10.4251/wjgo.v13.i3.161.
BACKGROUND
The association between body mass index (BMI) and clinical outcomes remains unclear among patients with resectable gastric cancer.
AIM
To investigate the relationship between BMI and long-term survival of gastric cancer patients.
METHODS
This retrospective study included 2526 patients who underwent radical gastrectomy for gastric cancer between September 2013 and June 2018. The patients were divided into four groups: Group A (low BMI, < 18.5 kg/m), group B (normal BMI, 18.5-24.9 kg/m), group C (overweight, 25-29.9 kg/m), and group D (obese, ≥ 30 kg/m). Clinicopathological findings and survival outcomes were recorded and analyzed.
RESULTS
Preoperative weight loss was more common in the low-BMI group, while diabetes was more common in the obese group. Upper-third gastric cancer accounted for a large proportion of cases in the higher BMI groups. Major perioperative complications tended to increase with BMI. The 5-year overall survival rates were 66.4% for group A, 75.0% for group B, 77.1% for group C, and 78.6% for group D. The 5-year overall survival rate was significantly lower in group A than in group C ( = 0.008) or group D ( = 0.031). Relative to a normal BMI value, a BMI of < 18.5 kg/m was associated with poor survival (hazard ratio: 1.558, 95% confidence interval: 1.125-2.158, = 0.008).
CONCLUSION
Low BMI, but not high BMI, independently predicted poor survival in patients with resectable gastric cancer.
背景
在可切除胃癌患者中，体重指数（BMI）与临床结局之间的关联仍不明确。
目的
探讨BMI与胃癌患者长期生存之间的关系。
方法
这项回顾性研究纳入了2013年9月至2018年6月期间接受胃癌根治性切除术的2526例患者。患者分为四组：A组（低BMI，<18.5kg/m²）、B组（正常BMI，18.5 - 24.9kg/m²）、C组（超重，25 - 29.9kg/m²）和D组（肥胖，≥30kg/m²）。记录并分析临床病理结果和生存结局。
结果
低BMI组术前体重减轻更为常见，而肥胖组糖尿病更为常见。高BMI组中上段胃癌病例占比很大。围手术期主要并发症倾向于随BMI增加而增多。A组5年总生存率为66.4%，B组为75.0%，C组为77.1%，D组为78.6%。A组5年总生存率显著低于C组（P = 0.008）或D组（P = 0.031）。相对于正常BMI值，BMI<18.5kg/m²与生存不良相关（风险比：1.558，95%置信区间：1.125 - 2.158，P = 0.008）。
结论
低BMI而非高BMI独立预测可切除胃癌患者的生存不良。
Zotero 插件