Einfluss des Body-Mass-Index auf die Prognose und Komplikationsrate nach Resektion beim Kardiakarzinom

Schumacher, Guido; Schlechtweg, N.; Ss, Chopra; Rösch, T; Veltzke‐Schlieker, Wilfried; Thuss-Patience, P.; Sc, Schmidt

doi:10.1055/s-0028-1098706

Cited by 5 publications

(5 citation statements)

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“…8,24 Moreover, these observations are supported by the results of randomized clinical trials confirming the detrimental effects of overweight. 5,25 Although some reports from Western populations revealed that BMI was not a significant predictor of postoperative morbidity 18,19 , the present findings strongly suggest that overweight may significantly contribute to the early postoperative outcomes. However, as in other reports, high BMI did not increase mortality rates, and thus cannot be responsible for the marked differences in long-term survival rates.…”

Section: Correlation Of Bmi With Postoperative Complicationscontrasting

confidence: 71%

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Implications of overweight in gastric cancer: A multicenter study in a Western patient population

Kulig

Sierżęga

Kołodziejczyk

et al. 2010

European Journal of Surgical Oncology (EJSO)

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AIMS: The purpose of this study was to evaluate the effects of overweight on surgical and long-term outcomes in a Western population of patients with gastric cancer (GC).METHODS: An electronic database of all patients with resectable GC treated between 1986 and 1998 at seven university surgical centres cooperating in the Polish Gastric Cancer Study Group was reviewed. Overweight was defined as a body mass index (BMI) of 25 kg/m 2 or higher.RESULTS: Four hundred and ninety-two of 1992 (25%) patients were overweight.Postoperatively, higher BMI was associated with higher rates of cardiopulmonary complications (16% vs 12%, P=0.001) and intra-abdominal abscess (6.9% vs 2.9%, P<0.001).However, other complications and mortality rates were unaffected. The median diseasespecific survival of overweight patients was significantly higher (36.7 months, 95%confidence interval (CI) 29.0 to 44.4) than those with BMI<25 kg/m 2 (25.7 months, 95%CI23.2 to 28.1; P=0.003). These differences were due to the lower frequencies of patients with T3 and T4 tumours, metastatic lymph nodes, distant metastases, and non-curative resections.A Cox proportional hazards model identified age, depth of infiltration, lymph node metastases, distant metastases, and residual tumour category as the independent prognostic factors.CONCLUSIONS: Overweight is not the independent prognostic factor for long-term survival in a Western-type population of GC.

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Section: Correlation Of Bmi With Postoperative Complicationscontrasting

confidence: 71%

“…Moreover, the paucity of studies concerning Western populations and potential flaws in reports from single institutions or including only a limited number of patients preclude a reliable evaluation of existing data. [17][18][19] M A N U S C R I P T…”

Section: Introductionmentioning

confidence: 99%

Implications of overweight in gastric cancer: A multicenter study in a Western patient population

Kulig

Sierżęga

Kołodziejczyk

et al. 2010

European Journal of Surgical Oncology (EJSO)

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“…As the search flow diagram showed (Figure 3), 14 studies including the current study, were included in our meta-analysis (Table 3) (Trivers et al , 2005; Healy et al , 2007; Morgan et al , 2007; Schumacher et al , 2009; Skipworth et al , 2009; Grotenhuis et al, 2010; Hayashi et al , 2010; Madani et al , 2010; Melis et al , 2011; Yoon et al , 2011; Zhu et al , 2011; Blom et al , 2012; Scarpa et al , 2012). Of the 14 studies, 7 studies were conducted in Europe, 4 in the United States, 2 in China and 1 in Canada, 1 study published in German, 1 in Chinese with English abstract and others were all in English.…”

Section: Resultsmentioning

confidence: 99%

“…However, there is no general consensus on the influence of BMI on survival in oesophageal cancer. Some studies suggested that patients with higher BMI had a significantly better prognosis than those with lower BMI (Smith et al , 2008; Hayashi et al , 2010; Melis et al , 2011; Kayani et al , 2012; Scarpa et al , 2012), whereas others yielded conflicting results (Healy et al , 2007; Morgan et al , 2007; Schumacher et al , 2009; Skipworth et al , 2009; Grotenhuis et al , 2010; Madani et al , 2010; Yoon et al , 2011; Blom et al , 2012). In addition, whether patients with higher BMI would have an increased incidence of postoperative complication is still debated.…”

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confidence: 99%

The impact of body mass index on complication and survival in resected oesophageal cancer: a clinical-based cohort and meta-analysis

et al. 2013

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Background:Body mass index (BMI) has been associated with the risk of oesophageal cancer. But the influence of BMI on postoperative complication and prognosis has always been controversial.Methods:In total, 2031 consecutive patients who underwent oesophagectomy between 1998 and 2008 were classified according to Asian-specific BMI (kg m−2) cutoff values. The impact of BMI on overall survival (OS) was estimated using the Kaplan–Meier method and Cox proportional hazard models. We performed a meta-analysis to examine the association of BMI with OS and postoperative complication.Results:Patients with higher BMI had more postoperative complication (P=0.002), such as anastomotic leakage (P=0.016) and cardiovascular diseases (P<0.001), but less incidence of chylous leakage (P=0.010). Logistic regression analysis showed that BMI (P=0.005) was a confounding factor associated with postoperative complication. Multivariate analysis showed that overweight and obese patients had a more favourable survival than normal weight patients (HR (hazard ratio) = 0.80, 95% CI (confidence interval): 0.70–0.92, P=0.001). Subgroup analysis showed that the association with higher BMI and increased OS was observed in patients with oesophageal squamous cell carcinoma (ESCC) (P<0.001), oesophageal adenocarcinoma (EA) (P=0.034), never-smoking (P=0.035), ever-smoking (P=0.035), never alcohol consumption (P=0.005), weight loss (P=0.003) and advanced pathological stage (P<0.001). The meta-analysis further corroborated that higher BMI was associated with increased complication of anastomotic leakage (RR (risk ratio)=1.04, 95% CI: 1.02–1.06, P=0.001), wound infection (RR=1.03, 95% CI: 1.00–1.05, P=0.031) and cardiovascular diseases (RR=1.02, 95% CI: 1.00–1.05, P=0.039), but decreased incidence of chylous leakage (RR=0.98, 95% CI: 0.96–0.99, P<0.001). In addition, high BMI could significantly improved OS (HR=0.78, 95% CI: 0.71–0.85, P<0.001).Conclusion:Preoperative BMI was an independent prognostic factor for survival, and strongly associated with postoperative complications in oesophageal cancer.

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“…[27]. Auch ein erhöhter Body-Mass-Index verursachte keine Veränderung der Prognose [18,26], Insgesamt scheinen die verschiedenen Prognosefaktoren, die zu einer Verschlechterung des Überlebens führen, häufig miteinander verknüpft zu sein, so dass ein höheres Tumorstadium häufiger einen fortgeschrittenen Lymphknotenstatus, eine Angio-und Lymphangioinvasion sowie ein höheres Grading nach sich zieht. So kann zwar für jeden einzelnen Prognosefaktor ein signifikanter Unterschied des Überlebens errechnet werden, jedoch wird die echte Prognose durch eine Kombination verschiedener oder aller Prognosefaktoren bestimmt [3,4,6,12,13,21,24,25,35].…”

Section: Diskussion !unclassified

Klinisch-pathologische Prognosefaktoren des Adenokarzinoms des gastroösophagealen Übergangs

et al. 2009

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Einfluss des Body-Mass-Index auf die Prognose und Komplikationsrate nach Resektion beim Kardiakarzinom

Abstract: Our data show that patients with elevated BMI have slightly more complications and an identical long term survival as patients with normal body weight.

Cited by 5 publications

References 4 publications

Implications of overweight in gastric cancer: A multicenter study in a Western patient population

Implications of overweight in gastric cancer: A multicenter study in a Western patient population

The impact of body mass index on complication and survival in resected oesophageal cancer: a clinical-based cohort and meta-analysis

Klinisch-pathologische Prognosefaktoren des Adenokarzinoms des gastroösophagealen Übergangs

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