Faculty Collaboration Database

Influence of body mass index on complications and oncologic outcomes following hepatectomy for malignancy. J Gastrointest Surg 2010 May;14(5):849-57

Date

02/09/2010

Pubmed ID

20140536

DOI

10.1007/s11605-010-1163-5

Scopus ID

2-s2.0-77952550573 (requires institutional sign-in at Scopus site)   44 Citations

Abstract

BACKGROUND: Following hepatectomy for malignancy, the effect of body mass index (BMI) on hepatic and oncologic outcomes is unknown.

METHODS: Two hundred seventy-nine post-hepatectomy patients with malignancy from our center were included in the cohort (1996-2006). BMI was categorized using World Health Organization criteria. The effect of BMI was evaluated using risk-adjusted Cox models for time to recurrence and overall survival.

RESULTS: Seventy-nine patients (28.3%) had primary hepatobiliary cancers, 134 (48.0%) had colorectal metastases, and 66 (25.3%) had other metastases. Thirty-five percent of patients were obese (BMI > 30). Obese patients had more hepatic-specific perioperative complications (27.8% vs. 15.9%, p = 0.018), bile leaks (18.6% vs. 9.9%, p = 0.030), post-operative pneumonia (9.3% vs. 2.2%, p = 0.0074), intra-abdominal abscesses (7.2% vs. 1.7%, p = 0.017), acute renal failure (7.2% vs. 1.7%, p = 0.017), urinary tract infections (16.4% vs. 7.7%, p = 0.024), and longer lengths of stay (10.5 vs.8.6 days, p = 0.029). Obese and non-obese patients had similar perioperative mortality, time to recurrence, and overall survival on univariate analysis. However, after adjusting for demographic, tumor, and operative characteristics, and complications, increasing BMI displayed improved recurrence-free (HR 0.90, 95% CI 0.86-0.95) and overall survival (HR 0.96, 95% CI 0.92-0.99).

CONCLUSIONS: High BMI patients may have better oncologic outcomes despite higher perioperative morbidity and hepatic complications following hepatectomy. These findings have important clinical and biological implications.

Author List

Mathur AK, Ghaferi AA, Sell K, Sonnenday CJ, Englesbe MJ, Welling TH

Author

Amir Ghaferi MD President, Phys Enterprise & SAD Clinical Affairs in the Medical College Physicians Administration department at Medical College of Wisconsin

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

Age Factors
Aged
Body Mass Index
Cohort Studies
Confidence Intervals
Disease-Free Survival
Female
Follow-Up Studies
Hepatectomy
Humans
Kaplan-Meier Estimate
Liver Neoplasms
Male
Middle Aged
Neoplasm Recurrence, Local
Obesity
Odds Ratio
Postoperative Complications
Probability
Proportional Hazards Models
Reference Values
Retrospective Studies
Risk Assessment
Sex Factors
Survival Analysis