Role of body mass index in colon cancer patients in Taiwan.
OBJECTIVE
To determine the effect of body mass index (BMI) on the characteristics and overall outcome of colon cancer in Taiwan.


METHODS
From January 1995 to July 2003, 2138 patients with colon cancer were enrolled in this study. BMI categories (in kg/m²) were established according to the classification of the Department of Health of Taiwan. Postoperative morbidities and mortality, and survival analysis including overall survival (OS), disease-free survival (DFS), and cancer-specific survival (CSS) were compared across the BMI categories.


RESULTS
There were 164 (7.7%) underweight (BMI < 18.5 kg/m²), 1109 (51.9%) normal-weight (BMI = 18.5-23.9 kg/m²), 550 (25.7%) overweight (BMI = 24.0-26.9 kg/m²), and 315 (14.7%) obese (BMI ≥ 27 kg/m²) patients. Being female, apparently anemic, hypoalbuminemic, and having body weight loss was more likely among underweight patients than among the other patients (P < 0.001). Underweight patients had higher mortality rate (P = 0.007) and lower OS (P < 0.001) and DFS (P = 0.002) than the other patients. OS and DFS did not differ significantly between normal-weight, overweight, and obese patients, while CSS did not differ significantly with the BMI category.


CONCLUSIONS
In Taiwan, BMI does not significantly affect colon-CSS. Underweight patients had a higher rate of surgical mortality and a worse OS and DFS than the other patients. Obesity does not predict a worse survival.
Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, Chiayi 613, Taiwan.
Chih-Chien
CC
Chin
Yi-Hung
YH
Kuo
Chien-Yuh
CY
Yeh
Jinn-Shiun
JS
Chen
Reiping
R
Tang
Chung-Rong
CR
Changchien
Jeng-Yi
JY
Wang
Wen-Shih
WS
Huang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D003110:Colonic Neoplasms / Q000453:epidemiology* / Q000401:mortality*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate; D013624:Taiwan / Q000453:epidemiology