The Impact of Preoperative Low Body Mass Index on Postoperative Complications and Long-term Survival Outcomes in Gastric Cancer Patients

• Published in: Journal of gastric cancer Vol. 18; no. 3; pp. 274 - 286
• Main Authors: Kim, Chang Hyun, Park, Seung-Man, Kim, Jin-Jo
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Gastric Cancer Association 01.09.2018; 대한위암학회
• Subjects: Original; 일반외과학; Body mass index; Obesity; Stomach neoplasms; Underweight
• ISSN: 2093-582X; 2093-5641
• DOI: 10.5230/jgc.2018.18.e30

The aim of this study was to investigate the impact of preoperative low body mass index (BMI) on both the short- and long-term outcomes in patients with gastric cancer. A total of 510 patients with gastric cancer were divided into the following 3 groups: low BMI group (≤18.5 kg/m , n=51), normal BMI group (18.6-24.9 kg/m , n=308), and high BMI group (≥25.0 kg/m , n=151). There were significantly more stage III/IV patients in the low BMI group than in the other groups (P=0.001). Severe postoperative complications were more frequent (P=0.010) and the survival was worse (P<0.001) in the low BMI group. The subgroup analysis indicated that survival was worse in the low BMI group of the stage I/II subgroup (P=0.008). The severe postoperative complication rate was higher in the low BMI group of the stage III/IV subgroup (P=0.001), although the recurrence rate and survival did not differ in the stage III/IV subgroup among all the BMI groups. Low BMI was an independent poor prognostic factor in the stage I/II subgroup (disease-free survival: hazard ratio [HR], 13.521; 95% confidence interval [CI], 1.186-154.197; P=0.036 and overall survival: HR, 5.130; 95% CI, 1.644-16.010; P=0.005), whereas low BMI was an independent risk factor for severe postoperative complications in the stage III/IV subgroup (HR, 17.158; 95% CI, 1.383-212.940; P=0.027). Preoperative low BMI in patients with gastric cancer adversely affects survival among those with stage I/II disease and increases the severe postoperative complication rate among those with stage III/IV disease.