Low body mass index is an independent predictor of poor long-term prognosis among patients with resectable gastric cancer

Shuai Ma; Hao Liu; Fu-Hai Ma; Yang Li; Peng Jin; Hai-Tao Hu; Wen-Zhe Kang; Wei-Kun Li; Jian-Ping Xiong; Yan-Tao Tian

doi:10.4251/wjgo.v13.i3.161

Low body mass index is an independent predictor of poor long-term prognosis among patients with resectable gastric cancer

World J Gastrointest Oncol. 2021 Mar 15;13(3):161-173. doi: 10.4251/wjgo.v13.i3.161.

Authors

Shuai Ma¹, Hao Liu¹, Fu-Hai Ma¹, Yang Li¹, Peng Jin¹, Hai-Tao Hu¹, Wen-Zhe Kang¹, Wei-Kun Li¹, Jian-Ping Xiong¹, Yan-Tao Tian²

Affiliations

¹ 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.
² 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. tianyantao@cicams.ac.cn.

Abstract

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/m²), group B (normal BMI, 18.5-24.9 kg/m²), group C (overweight, 25-29.9 kg/m²), and group D (obese, ≥ 30 kg/m²). 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 (P = 0.008) or group D (P = 0.031). Relative to a normal BMI value, a BMI of < 18.5 kg/m² was associated with poor survival (hazard ratio: 1.558, 95% confidence interval: 1.125-2.158, P = 0.008).

Conclusion: Low BMI, but not high BMI, independently predicted poor survival in patients with resectable gastric cancer.

Keywords: Body mass index; Gastric cancer; Malnutrition; Obesity; Survival benefit.