title: High Body Mass Index Worsens Survival in Patients with Esophageal Squamous Cell Carcinoma after Esophagectomy.
abstract: OBJECTIVE
  To investigate the prognostic significance of body mass index (BMI) on the survival of patients with esophageal squamous cell carcinoma (ESCC) after esophagectomy.
  
  
  METHODS
  Between 2005 and 2008, 291 patients with ESCC who met the inclusion criteria were included in the study. The BMI cut-off values were as follows: 18.5-23 kg/m2 for normal weight; 23-27.5 kg/m2 for overweight; and ≥27.5 kg/m2 for those with obesity. Univariate and multivariate analyses were performed to identify prognostic factors for long-term survival.
  
  
  RESULTS
  Patients were divided into 3 groups: normal weight (n = 138), overweight (n = 103), and obese (n = 50). The median survival time was 56 months. The 5-year overall survival (OS) rates were 40.8, 44.7, and 20.8% for normal weight, overweight, and obese patients respectively (p < 0.05). Multivariate analysis identified BMI as an independent prognostic factor for OS (p < 0.05). For 179 patients without lymph node metastasis, the 5-year OS rates were 46.5, 50.7, and 27.0% for normal weight, overweight, and obese patients respectively (p < 0.05).
  
  
  CONCLUSIONS
  A BMI ≥27.5 kg/m2 has a distinctly adverse impact on the long-term survival of ESCC patients after esophagectomy. High BMI is a potential predictor of worse prognosis in ESCC patients, particularly in patients without lymph node metastasis.
authors.affiliation: Department of Esophageal Cancer, Tianjin Medical University Cancer Institute and Hospital, Tianjin, China.
authors.forename: Xiao-Feng
authors.initials: XF
authors.lastname: Duan
authors.forename: Peng
authors.initials: P
authors.lastname: Tang
authors.forename: Xiao-Bin
authors.initials: XB
authors.lastname: Shang
authors.forename: Hong-Jing
authors.initials: HJ
authors.lastname: Jiang
authors.forename: Qiang
authors.initials: Q
authors.lastname: Zhao
authors.forename: Zhen-Tao
authors.initials: ZT
authors.lastname: Yu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D002294:Carcinoma, Squamous Cell / Q000556:secondary / Q000601:surgery*; D004938:Esophageal Neoplasms / Q000473:pathology / Q000601:surgery*; D016629:Esophagectomy; D005260:Female; D006801:Humans; D056865:Ideal Body Weight; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Body mass index; Esophagectomy; Esophagus; Squamous cell carcinoma; Survival