title: Impact of body mass index on postoperative outcome of advanced gastric cancer after curative surgery.
abstract: BACKGROUND
  The impact of body mass index (BMI) on the outcome of advanced gastric cancer surgery is controversial. Between December 1987 and December 2006, a total of 947 advanced gastric cancer patients receiving curative resection with retrieved lymph node number >15 were studied and divided into three groups according to BMI (<25, 25-30, and >30 kg/m(2)).
  
  
  CONCLUSIONS
  With regard to comorbidities present prior to surgery, higher BMI patients were more likely to have heart disease, type 2 diabetes, and hypertension than lower BMI patients. Compared with BMI <25 kg/m(2), higher BMI patients had longer operative time and more surgery-related morbidity. Multivariate Cox proportional-hazard analysis showed that age, pathological T and N categories, and lymphovascular invasion were independent prognostic factors. The initial recurrence patterns, 5-year overall survival, and cancer-specific survival were similar among the three groups.
  
  
  CONCLUSIONS
  Only in stage III gastric cancer with BMI less than 25 kg/m(2) patients receiving total gastrectomy had a more advanced pathological N category and a worse prognosis compared to those receiving subtotal gastrectomy. Higher BMI was associated with longer operative time and more surgery-related morbidity than lower BMI. BMI alone is not an independent prognostic factor.
authors.affiliation: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, 201 Section 2 Shih-Pai Road, Taipei, 11217, Taiwan.
authors.forename: Yen-Shu
authors.initials: YS
authors.lastname: Lin
authors.forename: Kuo-Hung
authors.initials: KH
authors.lastname: Huang
authors.forename: Yuan-Tzu
authors.initials: YT
authors.lastname: Lan
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Fang
authors.forename: Jen-Hao
authors.initials: JH
authors.lastname: Chen
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Lo
authors.forename: Mao-Chih
authors.initials: MC
authors.lastname: Hsieh
authors.forename: Anna Fen-Yau
authors.initials: AF
authors.lastname: Li
authors.forename: Shih-Hwa
authors.initials: SH
authors.lastname: Chiou
authors.forename: Chew-Wun
authors.initials: CW
authors.lastname: Wu
mesh_terms: D000368:Aged; D001808:Blood Vessels / Q000473:pathology; D015992:Body Mass Index; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods; D006331:Heart Diseases / Q000150:complications; D006801:Humans; D006973:Hypertension / Q000150:complications; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D042601:Lymphatic Vessels / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D009367:Neoplasm Staging; D061646:Operative Time; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000150:complications / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate