Impact of body mass index on survival of esophageal squamous carcinoma patients in southern China.
BACKGROUND
Although high body mass index (BMI) increases risk for developing esophageal adenocarcinoma (EAC), the prognostic influence of BMI is unknown in esophageal squamous carcinoma.


METHODS
BMI was calculated using measured height and weight at the first diagnosis and categorized as overweight (25 to 29.9 kg/m(2)), normal (18.5 to 24.9 kg/m(2)) or underweight (<18.5 kg/m(2)). Survival was compared by using the log-rank test on the Kaplan-Meier life table. Multivariate Cox regression analysis was used to evaluate whether BMI was an independent prognostic factor for disease-specific survival (DSS).


RESULTS
Among 1,176 esophageal squamous carcinoma patients, 146 (12.4%) were categorized as overweight, and 277 (23.6%) underweight. More patients in the underweight group had anemia (P=0.001), weight loss (P=0.035) and R1 resection (P<0.001). Less patients in the underweight group received adjuvant chemotherapy (P=0.01). Patients in the overweight group had a higher incidence rate of high blood pressure (P<0.001), diabetes (P<0.001) and coronary artery diseases (P<0.001). Moreover, more patients in the overweight group had a lower TNM stage (P=0.003). In the univariated analysis, high BMI was significantly associated with better DSS (P=0.013).


CONCLUSIONS
After adjusting for covariates enrolled for study, high BMI was an independent prognostic factor in weight loss esophageal squamous carcinoma patients.
1 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 2 Department of Medical Oncology, 3 Department of VIP Region, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Chao
C
Ren
1 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 2 Department of Medical Oncology, 3 Department of VIP Region, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Xiu-Yu
XY
Cai
1 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 2 Department of Medical Oncology, 3 Department of VIP Region, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Miao-Zhen
MZ
Qiu
1 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 2 Department of Medical Oncology, 3 Department of VIP Region, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
De-Shen
DS
Wang
1 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 2 Department of Medical Oncology, 3 Department of VIP Region, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Feng-Hua
FH
Wang
1 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 2 Department of Medical Oncology, 3 Department of VIP Region, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Hui-Yan
HY
Luo
1 State Key Laboratory of Oncology in South China, Guangzhou 510060, China ; 2 Department of Medical Oncology, 3 Department of VIP Region, Sun Yat-sen University Cancer Center, Guangzhou 510060, China.
Rui-Hua
RH
Xu
Body mass index (BMI); esophageal squamous carcinoma; overweight; prognostic factor