Obesity is not associated with adverse outcome following surgical resection of oesophageal adenocarcinoma.
OBJECTIVE
To study the impact of obesity on postoperative morbidity and outcome following surgical resection of primary oesophageal adenocarcinoma (EADC).


METHODS
From a prospective database, we compared clinicopathological findings (age, gender, surgical approach, tumour differentiation and stage), postoperative mortality, morbidity, length of hospitalisation, disease-free survival (DFS) and overall survival (OS) between 56 obese (body mass index (BMI)≥30 mgkg(-2)) and 86 non-obese (BMI<30 mgkg(-2)) patients with EADC.


RESULTS
In this consecutive series, there were 118 male and 24 female patients with a median age of 63 years (range, 36-85 years). For all patients, the 5-year OS was 26.9%, with a median survival of 20 months. No significant differences (P>0.05) were found between obese and non-obese patients, with respect to age, gender, surgical approach (transthoracic vs transhiatal), pT-stage, duration of hospital stay, postoperative mortality or morbidity. However, compared with non-obese patients, obese patients had a higher frequency of postoperative respiratory complications (odds ratio (OR), 3.05; 95% confidence intervals (CIs), 1.29-7.17). DFS and OS at 5 years were increased for patients who were obese at the time of oesophageal resection (P=0.008).


CONCLUSIONS
Obesity is not associated with increased postoperative complication rates or adverse outcome following oesophageal resection, and should therefore not be considered a relative contraindication to the surgical management of EADC. The improved survival of obese patients who underwent oesophageal resection for EADC suggests that further investigation of the association between obesity and oesophageal malignancy is now warranted.
Madani
Koroush
K
Department of Surgery, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan S7N 0W8, Canada.
Zhao
Ronghua
R
Lim
Hyun Ja
HJ
Casson
Sharon M
SM
Casson
Alan G
AG
D000230:Adenocarcinoma / Q000150:complications / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D004812:Epidemiologic Methods; D004938:Esophageal Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications*; D016896:Treatment Outcome