Faculty Collaboration Database

An elevated body mass index does not reduce survival after esophagectomy for cancer. Ann Surg Oncol 2011 Mar;18(3):824-31

Date

09/25/2010

Pubmed ID

20865331

Pubmed Central ID

PMC4623586

DOI

10.1245/s10434-010-1336-1

Scopus ID

2-s2.0-79955718048 (requires institutional sign-in at Scopus site)   47 Citations

Abstract

BACKGROUND: Incidences of esophageal cancer and obesity are both rising in the United States. The aim of this study was to determine the influence of elevated body mass index on outcomes after esophagectomy for cancer.

METHODS: Overall and disease-free survivals in obese (BMI ≥ 30), overweight (BMI 25-29), and normal-weight (BMI 20-24) patients undergoing esophagectomy constituted the study end points. Survivals were calculated by the Kaplan-Meier method, and differences were analyzed by log rank method.

RESULTS: The study included 166 obese, 176 overweight, and 148 normal-weight patients. These three groups were similar in terms of demographics and comorbidities, with the exception of younger age (62.5 vs. 66.2 vs. 65.3 years, P = 0.002), and higher incidence of diabetes (23.5 vs. 11.4 vs. 10.1%, P = 0.001) and hiatal hernia (28.3 vs. 14.8 vs. 20.3%, P = 0.01) in obese patients. Rates of adenocarcinoma histology were higher in obese patients (90.8 vs. 90.9 vs. 82.5%, P = 0.03). Despite similar preoperative stage, obese patients were less likely to receive neoadjuvant treatment (47.6 vs. 54.5 vs. 66.2%, P = 0.004). Response to neoadjuvant treatment, type of surgery performed, extent of lymphadenectomy, rate of R0 resections, perioperative complications, and administration of adjuvant chemotherapy were not influenced by BMI. At a median follow-up of 25 months, 5-year overall and disease-free survivals were longer in obese patients (respectively, 48, 41, 34%, P = 0.01 and 48, 44, 34%, P = 0.01).

CONCLUSIONS: In our experience, an elevated BMI did not reduce overall and disease-free survivals after esophagectomy for cancer.

Author List

Melis M, Weber JM, McLoughlin JM, Siegel EM, Hoffe S, Shridhar R, Turaga KK, Dittrick G, Dean EM, Karl RC, Meredith KL

MESH terms used to index this publication - Major topics in bold

Adenocarcinoma
Adult
Aged
Aged, 80 and over
Body Mass Index
Carcinoma, Squamous Cell
Combined Modality Therapy
Esophageal Neoplasms
Esophagectomy
Female
Humans
Lymph Node Excision
Lymphatic Metastasis
Male
Middle Aged
Neoadjuvant Therapy
Obesity
Overweight
Perioperative Care
Retrospective Studies
Survival Rate
Treatment Outcome