Body mass index and mortality in patients with gastric cancer: A large cohort study.

Authors

null

Jung Hwan Lee

National Cancer Center, Goyang, Korea, Republic of (South)

Jung Hwan Lee , Boram Park , Jungnam Joo , Young-Il Kim , Chan Gyoo Kim , Jong Yeul Lee , Il Ju Choi , Hong Man Yoon , Bang Wool Eom , Keun Won Ryu , Young Woo Kim , Soo-Jeong Cho

Organizations

National Cancer Center, Goyang, Korea, Republic of (South), National Cancer Center, Goyang, Republic of Korea, National Cancer Center, Goyang-Si, Korea, Republic of (South)

Research Funding

Other

Background: Although excess body weight has been known to be an important risk factor for mortality from many cancers including colorectal, endometrial and breast cancers, the prognosis of gastric cancer (GC) in obese patients seems controversial. Methods: We aimed to evaluate the association between body mass index (BMI) and mortality in GC in a large cohort. A single institute cohort of 7,765 GC patients undergoing curative gastrectomy between October 2000 and June 2016 were categorized into 6 groups; underweight (< 18.5 kg/m2), normal (18.5 to < 23 kg/m2), overweight (23 to < 25 kg/m2), obese I (25 to < 28 kg/m2), obese II (28 to < 30 kg/m2), and severely obese (≥30 kg/m2). The hazard ratios (HRs) for overall survival and disease-specific survival were calculated using Cox proportional hazard model. Results: We identified 1,279 all-cause and 763 disease-specific deaths among 7,765 patients, and the median follow-up period was 83.05 months (range, 1.02-186.97 months). In multivariable analyses adjusted by age, sex, tumor stage, comorbidity and operation methods, preoperative BMI was associated with all-cause mortality in a nonlinear pattern. As compared with patients who were normal weight, underweight BMI showed increasing mortality risk (hazard ratio (HR), 1.42, 95% confidence interval (CI), 1.15-1.77). In contrast, patients who were overweight (HR, 0.84; 95% CI, 0.73-0.97), obese I (HR, 0.77; 95% CI, 0.66-0.90) and obese II (HR, 0.77; 95% CI, 0.59-1.01) had lower risk of mortality. disease-specific mortality also had a similar pattern to overall survival showing the lowest mortality in obese II group (HR, 0.59; 95% CI, 0.40-0.88). There was no significant difference in severely obese patients in both all-cause and disease-specific mortalities. In spline analyses illustrated by a bell-shaped curve, risk for all-cause mortality was the lowest in patients with 26.67 kg/m2. Conclusions: Preoperative overweight and obese patients (23 to < 30 kg/m2) had lower all-cause and disease-specific mortalities compared to those with normal weight in GC patients who underwent curative surgical resection.

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Abstract Details

Meeting

2018 Gastrointestinal Cancers Symposium

Session Type

Poster Session

Session Title

Poster Session A: Cancers of the Esophagus and Stomach

Track

Cancers of the Esophagus and Stomach

Sub Track

Prevention, Diagnosis, and Screening

Citation

J Clin Oncol 36, 2018 (suppl 4S; abstr 16)

DOI

10.1200/JCO.2018.36.4_suppl.16

Abstract #

16

Poster Bd #

D16

Abstract Disclosures

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