title: Does body mass index impact the number of LNs harvested and influence long-term survival rate in patients with stage III colon cancer?
abstract: BACKGROUND
  The aim of this study is to evaluate whether different body mass index (BMI) values affect lymph node (LN) retrieval and whether such variations influence long-term survival in Asian patients.
  
  
  METHODS
  From January 1995 to July 2003, 645 stage III colon cancer patients were enrolled in our study. Patients were stratified into four groups: Obese (BMI ≧ 27 kg/m(2)), overweight (24 ≤ BMI < 27 kg/m(2)), normal (18.5 ≤ BMI < 24 kg/m(2)), and underweight (BMI < 18.5 kg/m(2)).
  
  
  RESULTS
  Mean BMI in the cohort was 23.3 kg/m(2). Mean number of LNs harvested was 23.1, 19.5, 19.8 and 28.1 in the normal, overweight, obese and underweight groups, respectively. There was a significant difference in the mean number of LNs harvested when comparing the overweight and underweight groups to the normal group (p = 0.013 and p = 0.04, respectively). Females were overrepresented in the underweight group (p = 0.011), and patients who had proximal colon cancers were more frequently underweight (p = 0.018). The mean number of LNs harvested varied by cases of right hemicolectomy (p = 0.009) and proximal cancer location (p = 0.009) for different BMI groups. Multivariate analysis showed that underweight, proximal colon cancer, well- or moderately differentiated adenocarcinoma and stage IIIC cancer were significant variables for adequate LN recovery. BMI was not significantly associated with relapse-free survival (p = 0.523) or overall survival (p = 0.127).
  
  
  CONCLUSIONS
  BMI is associated with LN harvest but is not an independent variable in stage III colon cancer survival.
authors.affiliation: Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, 6 West Chia-Pu Road, Putz City, Chiayi, 61363, Taiwan, Republic of China.
authors.forename: Yi-Hung
authors.initials: YH
authors.lastname: Kuo
authors.forename: Kam-Fai
authors.initials: KF
authors.lastname: Lee
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Chin
authors.forename: Wen-Shih
authors.initials: WS
authors.lastname: Huang
authors.forename: Chung-Hung
authors.initials: CH
authors.lastname: Yeh
authors.forename: Jeng-Yi
authors.initials: JY
authors.lastname: Wang
mesh_terms: D015992:Body Mass Index; D003110:Colonic Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology