Impact of body mass index on perioperative outcomes and survival after resection for gastric cancer

Aslam Ejaz, Gaya Spolverato, Yuhree Kim, George A. Poultsides, Ryan C. Fields, Mark Bloomston, Clifford S. Cho, Konstantinos Votanopoulos, Shishir K. Maithel, Timothy M. Pawlik

Research output: Contribution to journalArticle

Abstract

Background Among patients undergoing resection for gastric cancer, the impact of body mass index (BMI) on outcomes is not well understood. We sought to define the impact of non-normal BMI on short- and long-term outcomes after gastric cancer resection. Methods We identified 775 patients who underwent gastrectomy for adenocarcinoma between 2000 and 2012 from the multi-institutional US Gastric Cancer Collaborative. Clinicopathologic characteristics, operative details, and oncologic outcomes were collected, and patients were stratified according to BMI. Results Most patients in the cohort were classified as having normal BMI (n = 338, 43.6%), followed by overweight (n = 229, 29.6%), obese (n = 153, 19.7%), and underweight (n = 55, 7.1%). After stratifying by BMI, there were no significant differences in the incidence of postoperative blood transfusions, perioperative morbidity, postoperative infectious complications, length of stay, perioperative 30-d in-hospital death, or readmission across groups (all P > 0.05). BMI did not impact overall or recurrence-free survival after stratifying by stage (all P > 0.05). However, underweight patients with low preoperative albumin levels had worse overall survival (OS) compared with that of patients of normal BMI. Conclusions BMI did not impact perioperative morbidity, recurrence-free, or OS in patients undergoing gastric resection for adenocarcinoma. Underweight patients with BMI 2 and low preoperative albumin levels, however, had a significantly decreased OS after gastrectomy for cancer. These high-risk patients should have their nutritional status optimized both before and after gastrectomy in an attempt to modify this risk factor and, in turn, achieve better outcomes.

Original languageEnglish (US)
Pages (from-to)74-82
Number of pages9
JournalJournal of Surgical Research
Volume195
Issue number1
DOIs
StatePublished - May 1 2015

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Stomach Neoplasms
Body Mass Index
Survival
Thinness
Gastrectomy
Albumins
Adenocarcinoma
Morbidity
Recurrence
Nutritional Status
Blood Transfusion
Length of Stay
Stomach
Incidence
Neoplasms

Keywords

  • BMI
  • Gastrectomy
  • Gastric cancer
  • Obesity
  • Outcomes
  • Surgery
  • Underweight

ASJC Scopus subject areas

  • Surgery
  • Medicine(all)

Cite this

Ejaz, A., Spolverato, G., Kim, Y., Poultsides, G. A., Fields, R. C., Bloomston, M., ... Pawlik, T. M. (2015). Impact of body mass index on perioperative outcomes and survival after resection for gastric cancer. Journal of Surgical Research, 195(1), 74-82. https://doi.org/10.1016/j.jss.2014.12.048

Impact of body mass index on perioperative outcomes and survival after resection for gastric cancer. / Ejaz, Aslam; Spolverato, Gaya; Kim, Yuhree; Poultsides, George A.; Fields, Ryan C.; Bloomston, Mark; Cho, Clifford S.; Votanopoulos, Konstantinos; Maithel, Shishir K.; Pawlik, Timothy M.

In: Journal of Surgical Research, Vol. 195, No. 1, 01.05.2015, p. 74-82.

Research output: Contribution to journalArticle

Ejaz, A, Spolverato, G, Kim, Y, Poultsides, GA, Fields, RC, Bloomston, M, Cho, CS, Votanopoulos, K, Maithel, SK & Pawlik, TM 2015, 'Impact of body mass index on perioperative outcomes and survival after resection for gastric cancer', Journal of Surgical Research, vol. 195, no. 1, pp. 74-82. https://doi.org/10.1016/j.jss.2014.12.048
Ejaz, Aslam ; Spolverato, Gaya ; Kim, Yuhree ; Poultsides, George A. ; Fields, Ryan C. ; Bloomston, Mark ; Cho, Clifford S. ; Votanopoulos, Konstantinos ; Maithel, Shishir K. ; Pawlik, Timothy M. / Impact of body mass index on perioperative outcomes and survival after resection for gastric cancer. In: Journal of Surgical Research. 2015 ; Vol. 195, No. 1. pp. 74-82.
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abstract = "Background Among patients undergoing resection for gastric cancer, the impact of body mass index (BMI) on outcomes is not well understood. We sought to define the impact of non-normal BMI on short- and long-term outcomes after gastric cancer resection. Methods We identified 775 patients who underwent gastrectomy for adenocarcinoma between 2000 and 2012 from the multi-institutional US Gastric Cancer Collaborative. Clinicopathologic characteristics, operative details, and oncologic outcomes were collected, and patients were stratified according to BMI. Results Most patients in the cohort were classified as having normal BMI (n = 338, 43.6{\%}), followed by overweight (n = 229, 29.6{\%}), obese (n = 153, 19.7{\%}), and underweight (n = 55, 7.1{\%}). After stratifying by BMI, there were no significant differences in the incidence of postoperative blood transfusions, perioperative morbidity, postoperative infectious complications, length of stay, perioperative 30-d in-hospital death, or readmission across groups (all P > 0.05). BMI did not impact overall or recurrence-free survival after stratifying by stage (all P > 0.05). However, underweight patients with low preoperative albumin levels had worse overall survival (OS) compared with that of patients of normal BMI. Conclusions BMI did not impact perioperative morbidity, recurrence-free, or OS in patients undergoing gastric resection for adenocarcinoma. Underweight patients with BMI 2 and low preoperative albumin levels, however, had a significantly decreased OS after gastrectomy for cancer. These high-risk patients should have their nutritional status optimized both before and after gastrectomy in an attempt to modify this risk factor and, in turn, achieve better outcomes.",
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AU - Spolverato, Gaya

AU - Kim, Yuhree

AU - Poultsides, George A.

AU - Fields, Ryan C.

AU - Bloomston, Mark

AU - Cho, Clifford S.

AU - Votanopoulos, Konstantinos

AU - Maithel, Shishir K.

AU - Pawlik, Timothy M.

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N2 - Background Among patients undergoing resection for gastric cancer, the impact of body mass index (BMI) on outcomes is not well understood. We sought to define the impact of non-normal BMI on short- and long-term outcomes after gastric cancer resection. Methods We identified 775 patients who underwent gastrectomy for adenocarcinoma between 2000 and 2012 from the multi-institutional US Gastric Cancer Collaborative. Clinicopathologic characteristics, operative details, and oncologic outcomes were collected, and patients were stratified according to BMI. Results Most patients in the cohort were classified as having normal BMI (n = 338, 43.6%), followed by overweight (n = 229, 29.6%), obese (n = 153, 19.7%), and underweight (n = 55, 7.1%). After stratifying by BMI, there were no significant differences in the incidence of postoperative blood transfusions, perioperative morbidity, postoperative infectious complications, length of stay, perioperative 30-d in-hospital death, or readmission across groups (all P > 0.05). BMI did not impact overall or recurrence-free survival after stratifying by stage (all P > 0.05). However, underweight patients with low preoperative albumin levels had worse overall survival (OS) compared with that of patients of normal BMI. Conclusions BMI did not impact perioperative morbidity, recurrence-free, or OS in patients undergoing gastric resection for adenocarcinoma. Underweight patients with BMI 2 and low preoperative albumin levels, however, had a significantly decreased OS after gastrectomy for cancer. These high-risk patients should have their nutritional status optimized both before and after gastrectomy in an attempt to modify this risk factor and, in turn, achieve better outcomes.

AB - Background Among patients undergoing resection for gastric cancer, the impact of body mass index (BMI) on outcomes is not well understood. We sought to define the impact of non-normal BMI on short- and long-term outcomes after gastric cancer resection. Methods We identified 775 patients who underwent gastrectomy for adenocarcinoma between 2000 and 2012 from the multi-institutional US Gastric Cancer Collaborative. Clinicopathologic characteristics, operative details, and oncologic outcomes were collected, and patients were stratified according to BMI. Results Most patients in the cohort were classified as having normal BMI (n = 338, 43.6%), followed by overweight (n = 229, 29.6%), obese (n = 153, 19.7%), and underweight (n = 55, 7.1%). After stratifying by BMI, there were no significant differences in the incidence of postoperative blood transfusions, perioperative morbidity, postoperative infectious complications, length of stay, perioperative 30-d in-hospital death, or readmission across groups (all P > 0.05). BMI did not impact overall or recurrence-free survival after stratifying by stage (all P > 0.05). However, underweight patients with low preoperative albumin levels had worse overall survival (OS) compared with that of patients of normal BMI. Conclusions BMI did not impact perioperative morbidity, recurrence-free, or OS in patients undergoing gastric resection for adenocarcinoma. Underweight patients with BMI 2 and low preoperative albumin levels, however, had a significantly decreased OS after gastrectomy for cancer. These high-risk patients should have their nutritional status optimized both before and after gastrectomy in an attempt to modify this risk factor and, in turn, achieve better outcomes.

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