Influence of overweight on patients with gastric cancer after undergoing curative gastrectomy: an analysis of 689 consecutive cases managed by a single center.
OBJECTIVE
Overweight (body mass index [calculated as weight in kilograms divided by height in meters squared], > or =25.0) has an effect on surgical results, postoperative complications, and long-term survival in patients with gastric cancer who underwent curative gastrectomy.


METHODS
Retrospective study from January 1, 1992, through December 31, 2002.


METHODS
Wakayama Medical University Hospital.


METHODS
This study included 689 patients who underwent curative gastrectomy (R0). Patients who underwent laparoscopic gastrectomy, gastrectomy with pancreaticoduodenectomy, gastrectomy with another organ resection (liver, colon, or ovary), or gastrectomy with thoracotomy were not included.


METHODS
Duration of operation, amount of blood loss, incidence of postoperative complications, and survival analysis.


RESULTS
The mean (SD) duration of the operation was longer in the overweight group (315 [75] minutes) than in the normal-weight group (277 [85] minutes) (P < .001). The mean (SD) intraoperative blood loss was larger in the overweight group (882 [764] mL) than in the normal-weight group (536 [410] mL) (P < .001). The rates of postoperative complications (anastomotic leakage, pancreatic fistula, and intra-abdominal abscess) were significantly higher in the overweight group (P < .05). Multivariate logistic regression analysis identified that postoperative complications were significantly associated with being overweight (P = .01) and with undergoing pancreatectomy (P = .03). Disease-specific and overall survival did not show any significant difference between the 2 groups.


CONCLUSIONS
Being overweight is not a poor risk factor for survival in patients with gastric cancer, although it is independently predictive of postoperative complications.
Ojima
Toshiyasu
T
Second Department of Surgery, Wakayama Medical University, School of Medicine, Kimiidera, Wakayama, Japan.
Iwahashi
Makoto
M
Nakamori
Mikihito
M
Nakamura
Masaki
M
Naka
Teiji
T
Ishida
Koichiro
K
Ueda
Kentaro
K
Katsuda
Masahiro
M
Iida
Takeshi
T
Tsuji
Toshiaki
T
Yamaue
Hiroki
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications*; D011183:Postoperative Complications / Q000209:etiology*; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000150:complications / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate