title: The prognostic influence of body mass index, resting energy expenditure and fasting blood glucose on postoperative patients with esophageal cancer.
abstract: BACKGROUND
  Body mass index (BMI), resting energy expenditure (REE) and fasting blood glucose (FBG) are major preoperative assessments of patients' nutrition and metabolic state. The relations and effects of these indices on esophageal cancer patients' postoperative short-term and long-term outcomes remain controversial and unclear. We aimed to study the impact of BMI, REE and FBG in esophageal cancer patients undergoing esophagectomy.
  
  
  METHODS
  Three hundred and six esophageal cancer patients who underwent esophagectomy were observed retrospectively. Clinical characteristics, postoperative complications and survival analysis were compared among different BMI, REE and FBG groups.
  
  
  RESULTS
  There were significant linear relationships between REE, BMI and FBG indices, patients with low BMI tended to have low REE (p < 0.001) and low FBG (p = 0.003). No significant difference was found in case of mortality and postoperative complications among different groups. Low BMI (X2= 6.141, p = 0.046), REE (X2= 6.630, p = 0.010) and FBG (X2= 5.379, p = 0.020) were related to poor survival. FBG ≤90 mg/dL was independently associated with poor survival (HR = 0.695; 95 % CI 0.489-0.987, p = 0.042). BMI and REE came to be stronger prognostic factors on lymph node-negative patients and proved to be independent prognostic indicators (HR = 0.540; 95 % CI 0.304-0.959, p = 0.035 and HR = 0.457; 95 % CI 0.216-0.967, p = 0.041, respectively).
  
  
  CONCLUSIONS
  BMI, REE and FBG are important prognostic factors in patients with esophageal cancer undergoing esophagectomy and preoperative evaluation of these indices help to determine the prognosis in these patients.
authors.affiliation: Department of Cardio-thoracic Surgery, HuaShan Hospital of Fudan University, Shanghai, 200040, People's Republic of China.
authors.forename: Ning
authors.initials: N
authors.lastname: Wu
authors.affiliation: Department of Cardio-thoracic Surgery, HuaShan Hospital of Fudan University, Shanghai, 200040, People's Republic of China.
authors.forename: Yongjun
authors.initials: Y
authors.lastname: Zhu
authors.affiliation: Department of General Surgery, HuaShan Hospital of Fudan University, Shanghai, 200040, China.
authors.forename: Dhruba
authors.initials: D
authors.lastname: Kadel
authors.affiliation: Department of Cardio-thoracic Surgery, HuaShan Hospital of Fudan University, Shanghai, 200040, People's Republic of China.
authors.forename: Liewen
authors.initials: L
authors.lastname: Pang
authors.affiliation: Department of Cardio-thoracic Surgery, HuaShan Hospital of Fudan University, Shanghai, 200040, People's Republic of China.
authors.forename: Gang
authors.initials: G
authors.lastname: Chen
authors.affiliation: Department of Cardio-thoracic Surgery, HuaShan Hospital of Fudan University, Shanghai, 200040, People's Republic of China. czm_md@163.com.
authors.forename: Zhiming
authors.initials: Z
authors.lastname: Chen
mesh_terms: D000368:Aged; D001481:Basal Metabolism / Q000502:physiology*; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D004938:Esophageal Neoplasms / Q000097:blood / Q000503:physiopathology* / Q000601:surgery; D016629:Esophagectomy / Q000401:mortality; D005215:Fasting / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D001786:Blood Glucose
keywords: Body mass index; Esophageal cancer; Fasting blood glucose; Prognosis; Resting energy expenditure