Overweight or Obesity is an Unfavorable Long-Term Prognostic Factor for Patients who Underwent Gastrectomy for Stage II/III Gastric Cancer
Background 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. Methods A total of 460 patients with Stage II and III GC who und...
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| Veröffentlicht in: | World journal of surgery 2019-07, Vol.43 (7), p.1766-1776 |
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| creator | Kambara, Yuichi Yuasa, Norihiro Takeuchi, Eiji Miyake, Hideo Nagai, Hidemasa Yoshioka, Yuichiro Okuno, Masataka Miyata, Kanji |
| description | Background
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.
Methods
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 |
| doi_str_mv | 10.1007/s00268-019-04969-1 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2187517874</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2187517874</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4928-7528f0db9d73041949870e81c7bdeab5e05ce416ca20bf6c25e131df184676b13</originalsourceid><addsrcrecordid>eNqNkc1u1DAUhSMEokPhBVggS2zYhF7_xHbYwYgpQSNNpbZiaTnOTZoqkxTb09G8Ak-NpykgsUAsLFvy9x0d6WTZawrvKYA6CwBM6hxomYMoZZnTJ9mCCs5yxhl_mi2AS5HelJ9kL0K4BaBKgnyenXDQDBRXi-zH5h79HvvuJpLJk02NoY8H0gdiR3I9tvZ-8rYekKynscuv0G_JhZ-6cQqxd2RlXUxWm86FjT2OMZD9zZTE5pg6RnJuQ_SYqO3hAbuMtkNSVWdVVc2fKWZpR4f-ZfastUPAV4_3aXa9-ny1_JKvN-fV8uM6d6JkOlcF0y00ddkoDoKWotQKUFOn6gZtXSAUDgWVzjKoW-lYgZTTpqVaSCVryk-zd3PunZ--7zBEs-2Dw2GwI067YBjVqqBKK5HQt3-ht9POj6ndkZIlUyXliWIz5fwUgsfW3Pl-a_3BUDDHpcy8lElLmYelzLHFm8foXb3F5rfya5oEfJiBfT_g4T8izbevl59WUHKhk8xnOSRv7ND_Kf6PTj8Bj5ivcg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2186927913</pqid></control><display><type>article</type><title>Overweight or Obesity is an Unfavorable Long-Term Prognostic Factor for Patients who Underwent Gastrectomy for Stage II/III Gastric Cancer</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>SpringerLink Journals</source><creator>Kambara, Yuichi ; Yuasa, Norihiro ; Takeuchi, Eiji ; Miyake, Hideo ; Nagai, Hidemasa ; Yoshioka, Yuichiro ; Okuno, Masataka ; Miyata, Kanji</creator><creatorcontrib>Kambara, Yuichi ; Yuasa, Norihiro ; Takeuchi, Eiji ; Miyake, Hideo ; Nagai, Hidemasa ; Yoshioka, Yuichiro ; Okuno, Masataka ; Miyata, Kanji</creatorcontrib><description>Background
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.
Methods
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
2
), stage, and postoperative adjuvant chemotherapy were analyzed to investigate the correlation with relapse-free survival (RFS).
Results
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
2
, 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
2
was 1.42 (95% confidence interval: 1.01–2.02,
p
= 0.0423) with reference to patients with BMI < 25 kg/m
2
. 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.
Conclusions
BMI ≥ 25 kg/m
2
is an unfavorable prognostic factor for patients who underwent gastrectomy for Stage II and III GC.</description><identifier>ISSN: 0364-2313</identifier><identifier>EISSN: 1432-2323</identifier><identifier>DOI: 10.1007/s00268-019-04969-1</identifier><identifier>PMID: 30820737</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abdominal Abscess - etiology ; Abdominal Surgery ; Abscesses ; Adult ; Aged ; Aged, 80 and over ; Body mass ; Body Mass Index ; Body size ; Body weight ; Cancer ; Cardiac Surgery ; Chemotherapy ; Chemotherapy, Adjuvant ; Confidence intervals ; Correlation analysis ; Disease-Free Survival ; Epidemiology ; Female ; Gastrectomy ; Gastrectomy - adverse effects ; Gastric cancer ; General Surgery ; Humans ; Lymph nodes ; Lymph Nodes - surgery ; Male ; Medical prognosis ; Medicine ; Medicine & Public Health ; Middle Aged ; Multivariate analysis ; Neoplasm Staging ; Obesity ; Obesity - complications ; Operative Time ; Original Scientific Report ; Overweight ; Patients ; Stomach Neoplasms - complications ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Surgery ; Surgical site infections ; Surgical Wound Infection - etiology ; Thoracic Surgery ; Vascular Surgery</subject><ispartof>World journal of surgery, 2019-07, Vol.43 (7), p.1766-1776</ispartof><rights>Société Internationale de Chirurgie 2019</rights><rights>2019 The Author(s) under exclusive licence to Société Internationale de Chirurgie</rights><rights>World Journal of Surgery is a copyright of Springer, (2019). All Rights Reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4928-7528f0db9d73041949870e81c7bdeab5e05ce416ca20bf6c25e131df184676b13</citedby><cites>FETCH-LOGICAL-c4928-7528f0db9d73041949870e81c7bdeab5e05ce416ca20bf6c25e131df184676b13</cites><orcidid>0000-0002-5242-6463</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00268-019-04969-1$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00268-019-04969-1$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,41464,42533,45550,45551,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30820737$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kambara, Yuichi</creatorcontrib><creatorcontrib>Yuasa, Norihiro</creatorcontrib><creatorcontrib>Takeuchi, Eiji</creatorcontrib><creatorcontrib>Miyake, Hideo</creatorcontrib><creatorcontrib>Nagai, Hidemasa</creatorcontrib><creatorcontrib>Yoshioka, Yuichiro</creatorcontrib><creatorcontrib>Okuno, Masataka</creatorcontrib><creatorcontrib>Miyata, Kanji</creatorcontrib><title>Overweight or Obesity is an Unfavorable Long-Term Prognostic Factor for Patients who Underwent Gastrectomy for Stage II/III Gastric Cancer</title><title>World journal of surgery</title><addtitle>World J Surg</addtitle><addtitle>World J Surg</addtitle><description>Background
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.
Methods
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
2
), stage, and postoperative adjuvant chemotherapy were analyzed to investigate the correlation with relapse-free survival (RFS).
Results
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
2
, 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
2
was 1.42 (95% confidence interval: 1.01–2.02,
p
= 0.0423) with reference to patients with BMI < 25 kg/m
2
. 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.
Conclusions
BMI ≥ 25 kg/m
2
is an unfavorable prognostic factor for patients who underwent gastrectomy for Stage II and III GC.</description><subject>Abdominal Abscess - etiology</subject><subject>Abdominal Surgery</subject><subject>Abscesses</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body mass</subject><subject>Body Mass Index</subject><subject>Body size</subject><subject>Body weight</subject><subject>Cancer</subject><subject>Cardiac Surgery</subject><subject>Chemotherapy</subject><subject>Chemotherapy, Adjuvant</subject><subject>Confidence intervals</subject><subject>Correlation analysis</subject><subject>Disease-Free Survival</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastrectomy - adverse effects</subject><subject>Gastric cancer</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Lymph nodes</subject><subject>Lymph Nodes - surgery</subject><subject>Male</subject><subject>Medical prognosis</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Multivariate analysis</subject><subject>Neoplasm Staging</subject><subject>Obesity</subject><subject>Obesity - complications</subject><subject>Operative Time</subject><subject>Original Scientific Report</subject><subject>Overweight</subject><subject>Patients</subject><subject>Stomach Neoplasms - complications</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Surgical site infections</subject><subject>Surgical Wound Infection - etiology</subject><subject>Thoracic Surgery</subject><subject>Vascular Surgery</subject><issn>0364-2313</issn><issn>1432-2323</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkc1u1DAUhSMEokPhBVggS2zYhF7_xHbYwYgpQSNNpbZiaTnOTZoqkxTb09G8Ak-NpykgsUAsLFvy9x0d6WTZawrvKYA6CwBM6hxomYMoZZnTJ9mCCs5yxhl_mi2AS5HelJ9kL0K4BaBKgnyenXDQDBRXi-zH5h79HvvuJpLJk02NoY8H0gdiR3I9tvZ-8rYekKynscuv0G_JhZ-6cQqxd2RlXUxWm86FjT2OMZD9zZTE5pg6RnJuQ_SYqO3hAbuMtkNSVWdVVc2fKWZpR4f-ZfastUPAV4_3aXa9-ny1_JKvN-fV8uM6d6JkOlcF0y00ddkoDoKWotQKUFOn6gZtXSAUDgWVzjKoW-lYgZTTpqVaSCVryk-zd3PunZ--7zBEs-2Dw2GwI067YBjVqqBKK5HQt3-ht9POj6ndkZIlUyXliWIz5fwUgsfW3Pl-a_3BUDDHpcy8lElLmYelzLHFm8foXb3F5rfya5oEfJiBfT_g4T8izbevl59WUHKhk8xnOSRv7ND_Kf6PTj8Bj5ivcg</recordid><startdate>20190715</startdate><enddate>20190715</enddate><creator>Kambara, Yuichi</creator><creator>Yuasa, Norihiro</creator><creator>Takeuchi, Eiji</creator><creator>Miyake, Hideo</creator><creator>Nagai, Hidemasa</creator><creator>Yoshioka, Yuichiro</creator><creator>Okuno, Masataka</creator><creator>Miyata, Kanji</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>H94</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5242-6463</orcidid></search><sort><creationdate>20190715</creationdate><title>Overweight or Obesity is an Unfavorable Long-Term Prognostic Factor for Patients who Underwent Gastrectomy for Stage II/III Gastric Cancer</title><author>Kambara, Yuichi ; Yuasa, Norihiro ; Takeuchi, Eiji ; Miyake, Hideo ; Nagai, Hidemasa ; Yoshioka, Yuichiro ; Okuno, Masataka ; Miyata, Kanji</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4928-7528f0db9d73041949870e81c7bdeab5e05ce416ca20bf6c25e131df184676b13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Abdominal Abscess - etiology</topic><topic>Abdominal Surgery</topic><topic>Abscesses</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Body mass</topic><topic>Body Mass Index</topic><topic>Body size</topic><topic>Body weight</topic><topic>Cancer</topic><topic>Cardiac Surgery</topic><topic>Chemotherapy</topic><topic>Chemotherapy, Adjuvant</topic><topic>Confidence intervals</topic><topic>Correlation analysis</topic><topic>Disease-Free Survival</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Gastrectomy - adverse effects</topic><topic>Gastric cancer</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Lymph nodes</topic><topic>Lymph Nodes - surgery</topic><topic>Male</topic><topic>Medical prognosis</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Multivariate analysis</topic><topic>Neoplasm Staging</topic><topic>Obesity</topic><topic>Obesity - complications</topic><topic>Operative Time</topic><topic>Original Scientific Report</topic><topic>Overweight</topic><topic>Patients</topic><topic>Stomach Neoplasms - complications</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgery</topic><topic>Surgical site infections</topic><topic>Surgical Wound Infection - etiology</topic><topic>Thoracic Surgery</topic><topic>Vascular Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kambara, Yuichi</creatorcontrib><creatorcontrib>Yuasa, Norihiro</creatorcontrib><creatorcontrib>Takeuchi, Eiji</creatorcontrib><creatorcontrib>Miyake, Hideo</creatorcontrib><creatorcontrib>Nagai, Hidemasa</creatorcontrib><creatorcontrib>Yoshioka, Yuichiro</creatorcontrib><creatorcontrib>Okuno, Masataka</creatorcontrib><creatorcontrib>Miyata, Kanji</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>World journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kambara, Yuichi</au><au>Yuasa, Norihiro</au><au>Takeuchi, Eiji</au><au>Miyake, Hideo</au><au>Nagai, Hidemasa</au><au>Yoshioka, Yuichiro</au><au>Okuno, Masataka</au><au>Miyata, Kanji</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Overweight or Obesity is an Unfavorable Long-Term Prognostic Factor for Patients who Underwent Gastrectomy for Stage II/III Gastric Cancer</atitle><jtitle>World journal of surgery</jtitle><stitle>World J Surg</stitle><addtitle>World J Surg</addtitle><date>2019-07-15</date><risdate>2019</risdate><volume>43</volume><issue>7</issue><spage>1766</spage><epage>1776</epage><pages>1766-1776</pages><issn>0364-2313</issn><eissn>1432-2323</eissn><abstract>Background
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.
Methods
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
2
), stage, and postoperative adjuvant chemotherapy were analyzed to investigate the correlation with relapse-free survival (RFS).
Results
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
2
, 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
2
was 1.42 (95% confidence interval: 1.01–2.02,
p
= 0.0423) with reference to patients with BMI < 25 kg/m
2
. 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.
Conclusions
BMI ≥ 25 kg/m
2
is an unfavorable prognostic factor for patients who underwent gastrectomy for Stage II and III GC.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><pmid>30820737</pmid><doi>10.1007/s00268-019-04969-1</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-5242-6463</orcidid></addata></record> |
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| ispartof | World journal of surgery, 2019-07, Vol.43 (7), p.1766-1776 |
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| language | eng |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; SpringerLink Journals |
| subjects | Abdominal Abscess - etiology Abdominal Surgery Abscesses Adult Aged Aged, 80 and over Body mass Body Mass Index Body size Body weight Cancer Cardiac Surgery Chemotherapy Chemotherapy, Adjuvant Confidence intervals Correlation analysis Disease-Free Survival Epidemiology Female Gastrectomy Gastrectomy - adverse effects Gastric cancer General Surgery Humans Lymph nodes Lymph Nodes - surgery Male Medical prognosis Medicine Medicine & Public Health Middle Aged Multivariate analysis Neoplasm Staging Obesity Obesity - complications Operative Time Original Scientific Report Overweight Patients Stomach Neoplasms - complications Stomach Neoplasms - pathology Stomach Neoplasms - surgery Surgery Surgical site infections Surgical Wound Infection - etiology Thoracic Surgery Vascular Surgery |
| title | Overweight or Obesity is an Unfavorable Long-Term Prognostic Factor for Patients who Underwent Gastrectomy for Stage II/III Gastric Cancer |
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