Prognostic significance of body mass indices for patients undergoing esophagectomy for cancer
The aim of this study was to determine the role of body mass index (BMI) in a Western population on outcomes after esophagectomy for cancer. Two hundred and fifteen consecutive patients undergoing esophagectomy for esophageal cancer of any cell type were studied prospectively. Patients with BMIs >...
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| Veröffentlicht in: | Diseases of the esophagus 2007-02, Vol.20 (1), p.29-35 |
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| creator | Morgan, M. A. Lewis, W. G. Hopper, A. N. Escofet, X. Harvard, T. J. Brewster, A. E. Crosby, T. D. L. Roberts, S. A. Clark, G. W. B. |
| description | The aim of this study was to determine the role of body mass index (BMI) in a Western population on outcomes after esophagectomy for cancer. Two hundred and fifteen consecutive patients undergoing esophagectomy for esophageal cancer of any cell type were studied prospectively. Patients with BMIs > 25 kg/m were classified as overweight and compared with control patients with BMIs below these reference values. Ninety‐seven patients (45%) had low or normal BMIs, 86 patients (40%) were overweight, and a further 32 (15%) were obese. High BMIs were associated with a higher incidence of adenocarcinoma versus squamous cell carcinoma (83%vs. 14%, P = 0.041). Operative morbidity and mortality were 53% and 3% in overweight patients compared with 49% (P = 0.489) and 8% (P = 0.123) in control patients. Cumulative survival at 5 years was 27% for overweight patients compared with 38% for control patients (P = 0.6896). In a multivariate analysis, age (hazard ratio [HR] 1.492, 95% CI 1.143–1.948, P = 0.003), T‐stage (HR 1.459, 95% CI 1.028–2.071, P = 0.034), N‐stage (HR 1.815, 95% CI 1.039–3.172, P = 0.036) and the number of lymph node metastases (HR 1.008, 95% CI 1.023–1.158, P = 0.008), were significantly and independently associated with durations of survival. High BMIs were not associated with increased operative risk, and long‐term outcomes were similar after R0 esophagectomy. |
| doi_str_mv | 10.1111/j.1442-2050.2007.00637.x |
| format | Article |
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A. ; Lewis, W. G. ; Hopper, A. N. ; Escofet, X. ; Harvard, T. J. ; Brewster, A. E. ; Crosby, T. D. L. ; Roberts, S. A. ; Clark, G. W. B.</creator><creatorcontrib>Morgan, M. A. ; Lewis, W. G. ; Hopper, A. N. ; Escofet, X. ; Harvard, T. J. ; Brewster, A. E. ; Crosby, T. D. L. ; Roberts, S. A. ; Clark, G. W. B.</creatorcontrib><description>The aim of this study was to determine the role of body mass index (BMI) in a Western population on outcomes after esophagectomy for cancer. Two hundred and fifteen consecutive patients undergoing esophagectomy for esophageal cancer of any cell type were studied prospectively. Patients with BMIs > 25 kg/m were classified as overweight and compared with control patients with BMIs below these reference values. Ninety‐seven patients (45%) had low or normal BMIs, 86 patients (40%) were overweight, and a further 32 (15%) were obese. High BMIs were associated with a higher incidence of adenocarcinoma versus squamous cell carcinoma (83%vs. 14%, P = 0.041). Operative morbidity and mortality were 53% and 3% in overweight patients compared with 49% (P = 0.489) and 8% (P = 0.123) in control patients. Cumulative survival at 5 years was 27% for overweight patients compared with 38% for control patients (P = 0.6896). In a multivariate analysis, age (hazard ratio [HR] 1.492, 95% CI 1.143–1.948, P = 0.003), T‐stage (HR 1.459, 95% CI 1.028–2.071, P = 0.034), N‐stage (HR 1.815, 95% CI 1.039–3.172, P = 0.036) and the number of lymph node metastases (HR 1.008, 95% CI 1.023–1.158, P = 0.008), were significantly and independently associated with durations of survival. High BMIs were not associated with increased operative risk, and long‐term outcomes were similar after R0 esophagectomy.</description><identifier>ISSN: 1120-8694</identifier><identifier>EISSN: 1442-2050</identifier><identifier>DOI: 10.1111/j.1442-2050.2007.00637.x</identifier><identifier>PMID: 17227307</identifier><language>eng</language><publisher>Melbourne, Australia: Blackwell Publishing Asia</publisher><subject>Adenocarcinoma - mortality ; Adenocarcinoma - pathology ; Adenocarcinoma - therapy ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Carcinoma, Squamous Cell - mortality ; Carcinoma, Squamous Cell - pathology ; Carcinoma, Squamous Cell - therapy ; Case-Control Studies ; Combined Modality Therapy ; esophageal cancer ; Esophageal Neoplasms - mortality ; Esophageal Neoplasms - pathology ; Esophageal Neoplasms - therapy ; Esophagectomy ; Female ; Follow-Up Studies ; Humans ; Lymph Node Excision ; Lymphatic Metastasis ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; surgery ; Survival Analysis</subject><ispartof>Diseases of the esophagus, 2007-02, Vol.20 (1), p.29-35</ispartof><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5217-c2f89ba5532c972a6f852d9ae06a08c4c8793f887caa59493b7dfd26c398888e3</citedby><cites>FETCH-LOGICAL-c5217-c2f89ba5532c972a6f852d9ae06a08c4c8793f887caa59493b7dfd26c398888e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fj.1442-2050.2007.00637.x$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fj.1442-2050.2007.00637.x$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17227307$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Morgan, M. A.</creatorcontrib><creatorcontrib>Lewis, W. G.</creatorcontrib><creatorcontrib>Hopper, A. N.</creatorcontrib><creatorcontrib>Escofet, X.</creatorcontrib><creatorcontrib>Harvard, T. J.</creatorcontrib><creatorcontrib>Brewster, A. E.</creatorcontrib><creatorcontrib>Crosby, T. D. L.</creatorcontrib><creatorcontrib>Roberts, S. A.</creatorcontrib><creatorcontrib>Clark, G. W. B.</creatorcontrib><title>Prognostic significance of body mass indices for patients undergoing esophagectomy for cancer</title><title>Diseases of the esophagus</title><addtitle>Dis Esophagus</addtitle><description>The aim of this study was to determine the role of body mass index (BMI) in a Western population on outcomes after esophagectomy for cancer. Two hundred and fifteen consecutive patients undergoing esophagectomy for esophageal cancer of any cell type were studied prospectively. Patients with BMIs > 25 kg/m were classified as overweight and compared with control patients with BMIs below these reference values. Ninety‐seven patients (45%) had low or normal BMIs, 86 patients (40%) were overweight, and a further 32 (15%) were obese. High BMIs were associated with a higher incidence of adenocarcinoma versus squamous cell carcinoma (83%vs. 14%, P = 0.041). Operative morbidity and mortality were 53% and 3% in overweight patients compared with 49% (P = 0.489) and 8% (P = 0.123) in control patients. Cumulative survival at 5 years was 27% for overweight patients compared with 38% for control patients (P = 0.6896). In a multivariate analysis, age (hazard ratio [HR] 1.492, 95% CI 1.143–1.948, P = 0.003), T‐stage (HR 1.459, 95% CI 1.028–2.071, P = 0.034), N‐stage (HR 1.815, 95% CI 1.039–3.172, P = 0.036) and the number of lymph node metastases (HR 1.008, 95% CI 1.023–1.158, P = 0.008), were significantly and independently associated with durations of survival. High BMIs were not associated with increased operative risk, and long‐term outcomes were similar after R0 esophagectomy.</description><subject>Adenocarcinoma - mortality</subject><subject>Adenocarcinoma - pathology</subject><subject>Adenocarcinoma - therapy</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body Mass Index</subject><subject>Carcinoma, Squamous Cell - mortality</subject><subject>Carcinoma, Squamous Cell - pathology</subject><subject>Carcinoma, Squamous Cell - therapy</subject><subject>Case-Control Studies</subject><subject>Combined Modality Therapy</subject><subject>esophageal cancer</subject><subject>Esophageal Neoplasms - mortality</subject><subject>Esophageal Neoplasms - pathology</subject><subject>Esophageal Neoplasms - therapy</subject><subject>Esophagectomy</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Humans</subject><subject>Lymph Node Excision</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Prognosis</subject><subject>surgery</subject><subject>Survival Analysis</subject><issn>1120-8694</issn><issn>1442-2050</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkMlOwzAURS0EYv4F5BW7BA-JhwULBGWQmIQYVshyHTu4NHGxU9H-Pekg2PI2fpLvuU86AECMctzPySjHRUEygkqUE4R4jhCjPJ9tgN3fj81-xwRlgsliB-ylNEIIc8rENtjBnBBOEd8F748x1G1InTcw-br1zhvdGguDg8NQzWGjU4K-rbyxCboQ4UR33rZdgtO2srEOvq2hTWHyoWtrutDMl6llSTwAW06Pkz1cv_vg5XLwfH6d3T5c3Zyf3WamJJhnhjghh7osKTGSE82cKEkltUVMI2EKI7ikTghutC5lIemQV64izFAp-rF0HxyveicxfE1t6lTjk7HjsW5tmCbFhCQlY7gPilXQxJBStE5Nom90nCuM1EKtGqmFQbUwqBZq1VKtmvXo0frGdNjY6g9cu-wDp6vAtx_b-b-L1cXD86Dfej5b8T51dvbL6_ipGKe8VG_3V4pzcn_3-vSonugPggyX7A</recordid><startdate>200702</startdate><enddate>200702</enddate><creator>Morgan, M. A.</creator><creator>Lewis, W. G.</creator><creator>Hopper, A. N.</creator><creator>Escofet, X.</creator><creator>Harvard, T. J.</creator><creator>Brewster, A. E.</creator><creator>Crosby, T. D. L.</creator><creator>Roberts, S. A.</creator><creator>Clark, G. W. B.</creator><general>Blackwell Publishing Asia</general><scope>BSCLL</scope><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>7X8</scope></search><sort><creationdate>200702</creationdate><title>Prognostic significance of body mass indices for patients undergoing esophagectomy for cancer</title><author>Morgan, M. A. ; Lewis, W. G. ; Hopper, A. N. ; Escofet, X. ; Harvard, T. J. ; Brewster, A. E. ; Crosby, T. D. L. ; Roberts, S. A. ; Clark, G. W. 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A.</creatorcontrib><creatorcontrib>Lewis, W. G.</creatorcontrib><creatorcontrib>Hopper, A. N.</creatorcontrib><creatorcontrib>Escofet, X.</creatorcontrib><creatorcontrib>Harvard, T. J.</creatorcontrib><creatorcontrib>Brewster, A. E.</creatorcontrib><creatorcontrib>Crosby, T. D. L.</creatorcontrib><creatorcontrib>Roberts, S. A.</creatorcontrib><creatorcontrib>Clark, G. W. B.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Diseases of the esophagus</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Morgan, M. A.</au><au>Lewis, W. G.</au><au>Hopper, A. N.</au><au>Escofet, X.</au><au>Harvard, T. J.</au><au>Brewster, A. E.</au><au>Crosby, T. D. L.</au><au>Roberts, S. A.</au><au>Clark, G. W. B.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic significance of body mass indices for patients undergoing esophagectomy for cancer</atitle><jtitle>Diseases of the esophagus</jtitle><addtitle>Dis Esophagus</addtitle><date>2007-02</date><risdate>2007</risdate><volume>20</volume><issue>1</issue><spage>29</spage><epage>35</epage><pages>29-35</pages><issn>1120-8694</issn><eissn>1442-2050</eissn><abstract>The aim of this study was to determine the role of body mass index (BMI) in a Western population on outcomes after esophagectomy for cancer. Two hundred and fifteen consecutive patients undergoing esophagectomy for esophageal cancer of any cell type were studied prospectively. Patients with BMIs > 25 kg/m were classified as overweight and compared with control patients with BMIs below these reference values. Ninety‐seven patients (45%) had low or normal BMIs, 86 patients (40%) were overweight, and a further 32 (15%) were obese. High BMIs were associated with a higher incidence of adenocarcinoma versus squamous cell carcinoma (83%vs. 14%, P = 0.041). Operative morbidity and mortality were 53% and 3% in overweight patients compared with 49% (P = 0.489) and 8% (P = 0.123) in control patients. Cumulative survival at 5 years was 27% for overweight patients compared with 38% for control patients (P = 0.6896). In a multivariate analysis, age (hazard ratio [HR] 1.492, 95% CI 1.143–1.948, P = 0.003), T‐stage (HR 1.459, 95% CI 1.028–2.071, P = 0.034), N‐stage (HR 1.815, 95% CI 1.039–3.172, P = 0.036) and the number of lymph node metastases (HR 1.008, 95% CI 1.023–1.158, P = 0.008), were significantly and independently associated with durations of survival. High BMIs were not associated with increased operative risk, and long‐term outcomes were similar after R0 esophagectomy.</abstract><cop>Melbourne, Australia</cop><pub>Blackwell Publishing Asia</pub><pmid>17227307</pmid><doi>10.1111/j.1442-2050.2007.00637.x</doi><tpages>7</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Diseases of the esophagus, 2007-02, Vol.20 (1), p.29-35 |
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| source | Oxford University Press Journals All Titles (1996-Current); MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adenocarcinoma - mortality Adenocarcinoma - pathology Adenocarcinoma - therapy Adult Aged Aged, 80 and over Body Mass Index Carcinoma, Squamous Cell - mortality Carcinoma, Squamous Cell - pathology Carcinoma, Squamous Cell - therapy Case-Control Studies Combined Modality Therapy esophageal cancer Esophageal Neoplasms - mortality Esophageal Neoplasms - pathology Esophageal Neoplasms - therapy Esophagectomy Female Follow-Up Studies Humans Lymph Node Excision Lymphatic Metastasis Male Middle Aged Multivariate Analysis Prognosis surgery Survival Analysis |
| title | Prognostic significance of body mass indices for patients undergoing esophagectomy for cancer |
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