Majewska Oliwia, Pach Radosław, Brzewski Paweł, Kulig Jan, Kulig Piotr
Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Krakow University, Krakow, Poland.
Jagiellonian University Medical College, Krakow, Poland.
In Vivo. 2025 Mar-Apr;39(2):1122-1133. doi: 10.21873/invivo.13917.
BACKGROUND/AIM: This study evaluated the influence of the body mass index (BMI) on outcomes of gastric cancer resection, with a specific focus on curative gastrectomy.
A total of 756 patients who underwent gastric cancer resection, including 372 cases of curative gastrectomy, were analyzed. The impact of BMI on overall, systemic, and surgical complications, as well as on relaparotomy, perioperative mortality, and 5-year survival was examined.
Underweight (BMI <18.5 kg/m), and obesity (BMI ≥30 kg/m) were identified as independent risk factors for overall complications (<0.0001, and <0.0001), systemic complications (<0.0001, and =0.001), and surgical complications (<0.0001, and =0.023) in all gastric cancer resections. Similar trends were observed for curative gastrectomy, where underweight and obese patients demonstrated more overall complications (<0.0001, and <0.0001), systemic complications (<0.001, and =0.0001), and surgical complications (<0.0001, and =0.0032). No differences in 5-year survival were observed among BMI categories in 372 cases of curative gastrectomy. However, being underweight was associated with a poorer 5-year survival in all 756 cases of gastric cancer resection (odds ratio=0.45, 95% confidence interval= 0.27-0.73, =0.0016).
BMI significantly influences the outcomes of gastric cancer resection, with underweight and obese patients demonstrating higher complication rates. Underweight status is also linked to poorer long-term survival in the broader gastric cancer population but not in curative resection cases.
背景/目的：本研究评估了体重指数（BMI）对胃癌切除术结局的影响，特别关注根治性胃切除术。
分析了总共756例行胃癌切除术的患者，其中包括372例根治性胃切除术。研究了BMI对总体、全身及手术并发症，以及再次剖腹手术、围手术期死亡率和5年生存率的影响。
在所有胃癌切除术中，体重过轻（BMI<18.5kg/m²）和肥胖（BMI≥30kg/m²）被确定为总体并发症（<0.0001和<0.0001）、全身并发症（<0.0001和=0.001）及手术并发症（<0.0001和=0.023）的独立危险因素。根治性胃切除术也观察到类似趋势，体重过轻和肥胖患者的总体并发症（<0.0001和<0.0001）、全身并发症（<0.001和=0.0001）及手术并发症（<0.0001和=0.0032）更多。在372例根治性胃切除术中，各BMI类别间5年生存率无差异。然而，在所有756例胃癌切除术中，体重过轻与较差的5年生存率相关（优势比=0.45，95%置信区间=0.27-0.73，P=0.0016）。
BMI显著影响胃癌切除术的结局，体重过轻和肥胖患者的并发症发生率更高。体重过轻状态在更广泛的胃癌人群中也与较差的长期生存率相关，但在根治性切除病例中并非如此。
