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Prognostic value of preoperative weight loss-adjusted body mass index on survival after esophagectomy for esophageal squamous cell carcinoma.
- Source :
-
World journal of gastroenterology [World J Gastroenterol] 2020 Feb 28; Vol. 26 (8), pp. 839-849. - Publication Year :
- 2020
-
Abstract
- Background: The impact of body mass index (BMI) on survival in patients with esophageal squamous cell carcinoma (ESCC) undergoing surgery remains unclear. Therefore, a definition of clinically significant BMI in patients with ESCC is needed.<br />Aim: To explore the impact of preoperative weight loss (PWL)-adjusted BMI on overall survival (OS) in patients undergoing surgery for ESCC.<br />Methods: This retrospective study consisted of 1545 patients who underwent curative resection for ESCC at West China Hospital of Sichuan University between August 2005 and December 2011. The relationship between PWL-adjusted BMI and OS was examined, and a multivariate analysis was performed and adjusted for age, sex, TNM stage and adjuvant therapy.<br />Results: Trends of poor survival were observed for patients with increasing PWL and decreasing BMI. Patients with BMI ≥ 20.0 kg/m <superscript>2</superscript> and PWL < 8.8% were classified into Group 1 with the longest median OS (45.3 mo). Patients with BMI < 20.0 kg/m <superscript>2</superscript> and PWL < 8.8% were classified into Group 2 with a median OS of 29.5 mo. Patients with BMI ≥ 20.0 kg/m <superscript>2</superscript> and PWL ≥ 8.8% (HR = 1.9, 95%CI: 1.5-2.5), and patients with BMI < 20.0 kg/m <superscript>2</superscript> and PWL ≥ 8.8% (HR = 2.0, 95%CI: 1.6-2.6), were combined into Group 3 with a median OS of 20.1 mo. Patients in the three groups were associated with significantly different OS ( P < 0.05). In multivariate analysis, PWL-adjusted BMI, TNM stage and adjuvant therapy were identified as independent prognostic factors.<br />Conclusion: PWL-adjusted BMI has an independent prognostic impact on OS in patients with ESCC undergoing surgery. BMI might be an indicator for patients with PWL < 8.8% rather than ≥ 8.8%.<br />Competing Interests: Conflict-of-interest statement: All authors declare no conflicts-of-interest related to this article.<br /> (©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.)
- Subjects :
- Aged
Chemotherapy, Adjuvant mortality
China
Esophageal Neoplasms physiopathology
Esophageal Neoplasms surgery
Esophageal Squamous Cell Carcinoma physiopathology
Esophageal Squamous Cell Carcinoma surgery
Female
Humans
Male
Middle Aged
Neoplasm Staging
Nutritional Status
Predictive Value of Tests
Preoperative Period
Prognosis
Retrospective Studies
Treatment Outcome
Body Mass Index
Esophageal Neoplasms mortality
Esophageal Squamous Cell Carcinoma mortality
Esophagectomy mortality
Weight Loss
Subjects
Details
- Language :
- English
- ISSN :
- 2219-2840
- Volume :
- 26
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- World journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 32148381
- Full Text :
- https://doi.org/10.3748/wjg.v26.i8.839