title: Prognostic value of body mass index for patients undergoing esophagectomy for esophageal squamous cell carcinoma.
abstract: OBJECTIVE
  The correlation between high body mass index and outcomes after esophagectomy has not been systematically addressed. Some studies have shown that patients with a high body mass index had better overall survival and disease-free survival compared with those with a normal/low body mass index, whereas others have shown that the body mass index was not of prognostic value.
  
  
  METHODS
  Ninety-nine patients with esophageal squamous cell carcinoma were retrospectively reviewed in this study. Patients' postoperative overall and disease-free survivals were compared between the two groups (body mass index <24.00 kg/m(2) and body mass index ≥24.00 kg/m(2)).
  
  
  RESULTS
  There were 66 patients in the low/normal body mass index group (body mass index <24.00 kg/m(2)) and 28 patients in the high body mass index group (body mass index ≥24.00 kg/m(2)). Although disease recurrence were more frequent in the high body mass index group vs. the low/normal body mass index group, there was no significant difference noted (60.7%, 40.9%, P = 0.078). The 3-year overall survival rates were 60.6% in the low/normal body mass index group and 57.1% in the high body mass index group (P = 0.392). The 3-year disease-free survival rates were higher in the low/normal body mass index group vs. the high body mass index group (56.1%, 39.3%, P = 0.048). On multivariate analysis, the number of lymph node metastases (hazard ratio: 1.192, 95% confidence interval: 1.076-1.320, P = 0.001) was recognized as an independent prognostic factor for overall survival. Both body weight loss (hazard ratio: 2.153, 95% confidence interval: 1.027-4.511, P = 0.042) and the number of lymph node metastases (hazard ratio: 1.669, 95% confidence interval: 1.297-2.146, P < 0.001) were significantly and independently associated with disease-free survival.
  
  
  CONCLUSIONS
  Our results suggest that high body mass index appears to shorten disease-free survival in esophageal squamous cell carcinoma patients and further studies are needed to detect the mechanism.
authors.affiliation: Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jiyan Rd. 440, Jinan 250117, Shandong Province, People's Republic of China.
authors.forename: Yufeng
authors.initials: Y
authors.lastname: Cheng
authors.forename: Nana
authors.initials: N
authors.lastname: Wang
authors.forename: Kai
authors.initials: K
authors.lastname: Wang
authors.forename: Jianbo
authors.initials: J
authors.lastname: Wang
authors.forename: Bingxu
authors.initials: B
authors.lastname: Tan
authors.forename: Yibin
authors.initials: Y
authors.lastname: Jia
authors.forename: Yan
authors.initials: Y
authors.lastname: Dou
authors.forename: Jinming
authors.initials: J
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D044466:Asian People / Q000706:statistics & numerical data*; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000150:complications / Q000401:mortality* / Q000601:surgery; D002681:China / Q000453:epidemiology; D018572:Disease-Free Survival; D004938:Esophageal Neoplasms / Q000150:complications / Q000401:mortality* / Q000601:surgery; D016629:Esophagectomy / Q000379:methods; D005260:Female; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D016019:Survival Analysis