title: Survival impact of postoperative body mass index in gastric cancer patients undergoing gastrectomy.
abstract: BACKGROUND
  The relationship between preoperative body mass index (BMI) and the survival of postoperative gastric cancer patients is not clear. Furthermore, the survival impact with postoperative BMI is not known, even though weight loss is inevitable after gastrectomy.
  
  
  METHODS
  Patients who underwent gastrectomy for gastric cancer between 2000 and 2008 were included in the study (n = 1909). Patients were divided into three groups based on their BMIs: low (<18.5 kg/m(2)), normal (18.5-24.9 kg/m(2)), and high BMI (≥ 25.0 kg/m(2)). Patient survival was compared according to BMI at two time points: baseline and 1 year after surgery.
  
  
  RESULTS
  Regarding BMI 1 year after surgery, overall survival, disease-specific survival, and recurrence-free survival were longer in the high BMI group than the low and normal BMI groups. In a Cox proportional hazards model, adjusting for the patient's age, sex, type of surgery, tumour stage, histology, curative resection, and BMI at baseline, a high BMI 1 year after surgery was associated with lower overall mortality compared to normal BMI (hazard ratio 0.51; 95% confidence interval, 0.26-0.98). However, BMI at baseline was not an independent prognostic factor.
  
  
  CONCLUSIONS
  BMI 1 year after surgery significantly predicted the long-term survival of patients with gastric cancer compared with the preoperative BMI.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Han Hee
authors.initials: HH
authors.lastname: Lee
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: parkjerry@catholic.ac.kr.
authors.forename: Jae Myung
authors.initials: JM
authors.lastname: Park
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Kyo Young
authors.initials: KY
authors.lastname: Song
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Myung-Gyu
authors.initials: MG
authors.lastname: Choi
authors.affiliation: Division of Gastrointestinal Surgery, Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Cho Hyun
authors.initials: CH
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D016009:Chi-Square Distribution; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000401:mortality; D006304:Health Status; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Body mass index; Gastrectomy; Prognosis; Stomach neoplasms; Survival