An Elevated Body Mass Index Does Not Reduce Survival After Esophagectomy for Cancer
| Autor: | Jill Weber, Sarah E. Hoffe, Ravi Shridhar, Marcovalerio Melis, Erin M. Siegel, Kiran K. Turaga, Richard C. Karl, Kenneth L. Meredith, James M. McLoughlin, George W. Dittrick, E. Michelle Dean |
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| Jazyk: | angličtina |
| Rok vydání: | 2010 |
| Předmět: |
Oncology
Adult Male medicine.medical_specialty Esophageal Neoplasms medicine.medical_treatment Overweight Adenocarcinoma Article Perioperative Care Body Mass Index Internal medicine medicine Humans Obesity Survival rate Aged Retrospective Studies Aged 80 and over business.industry Cancer Esophageal cancer Middle Aged medicine.disease Combined Modality Therapy Neoadjuvant Therapy Esophagectomy Survival Rate Treatment Outcome Lymphatic Metastasis Carcinoma Squamous Cell Lymph Node Excision Surgery Female medicine.symptom business Body mass index |
| Popis: | 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.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.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).In our experience, an elevated BMI did not reduce overall and disease-free survivals after esophagectomy for cancer. |
| Databáze: | OpenAIRE |
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