Effect of Body Mass Index on Short-term Outcome in Patients underwent Esophagectomy_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

KANQiang-bo ¹ ,  KOUYing-li ²

1. Department of Thoracic Surgery of Qujing City First People's Hospital, Qujing 655000 Yunan, P. R. China;
2. Department of Thoracic Surgery of West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

KOUYing-li, Email: kxyykou@126.com

Keywords：

Esophageal cancer; Body mass index; Surgery

DOI：

10.7507/1007-4848.20160245

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To explore the effect of body mass index (BMI) on therapeutic effect and surgical risk of esophagectomy. Methods We retrospectively collected the data of 494 patients who underwent esophagectomy in West China hospital of Sichuan University between March 2014 and March 2015. According to BMI, all patients were allocated to three groups: an obesity group (BMI≥25 kg/m²) of 74 patients, a normal weight group (18.5 kg/m²≤BMI < 25 kg/m²) of 345 patients, and a low weight group (BMI < 18.5 kg/m²) of 75 patients. Results There were no statistical differences in the intraoperative blood loss (213.33±55.10 ml vs. 218.90±60.76 ml vs. 217.30±61.10 ml), operation time (197.07±52.47 min vs. 208.35±96.84 min vs. 182.84±63.06 min), incidence of postoperative complication (38.7% (29/75) vs. 43.2% (149/345) vs. 39.2% (29/74), the number of resected lymphnodes (l16.18±6.64 vs. 16.68 ±8.48 vs. 8.48±8.26), and the number of the metastatic lymphnodes (1.42±2.53 vs. 1.32±2.51 vs. 2.45±4.08) among the low weight group, the normal weight group, and the obesity group. Conclusion Obesity and low weight do not increase the surgical risk and influence the surgical outcome. Therefore, obesity and low weight should not interfere with the operative choice of patients with esophageal cancer.

Citation： KANQiang-bo, KOUYing-li. Effect of Body Mass Index on Short-term Outcome in Patients underwent Esophagectomy. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(11): 1039-1043. doi: 10.7507/1007-4848.20160245 Copy

1.	Blom RL, Lagarde SM, Klinkenbijl JH, et al. A high body mass index in esophageal cancer patients does not influence postoperative outcome or long-term survival. Ann Surg Oncol, 2012, 19(3): 766-771.
2.	Healy LA, Ryan AM, Gopinath B, et al. Impact of obesity on outcomes in the management of localized adenocarcinoma of the esophagus and esophagogastric junction. J Thorac Cardiovasc Surg, 2007, 134(5): 1284-1291.
3.	Miao L, Chen H, Xiang J, et al. A high body mass index in esopha-geal cancer patients is not associated with adverse outcomes follo-wing esophagectomy. J Cancer Res Clin Oncol, 2015, 141(45): 941-950.
4.	Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
5.	Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2): 69-90.
6.	Holscher AH, Vallbohmer D, Brabender J. The prevention and management of perioperative complications. Best Pract Res Clin Gastroenterol, 2006, 20(5): 907-923.
7.	Markar SR, Karthikesalingam A, Low DE. Outcomes assessment of the surgical management of esophageal cancer in younger and older patients. Ann Thorac Surg, 2012, 94(45): 1652-1658.
8.	Scarpa M, Cagol M, Bettini S, et al. Overweight patients operated on for cancer of the esophagus survive longer than normal-weight patients. J Gastrointest Surg, 2013, 17(2): 218-227.
9.	Scipione CN, Chang AC, Pickens A, et al. Transhiatal esophagectomy in the profoundly obese: implications and experience. Ann Thorac Surg, 2007, 84(2): 376-383.
10.	Rustgi AK, El-Serag HB. Esophageal carcinoma. N Engl J Med, 2014, 371(26): 2499-2509.
11.	Hayashi Y, Correa AM, Hofstetter WL, et al. The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy. Cancer, 2010, 116(24): 5619-5627.
12.	Yoon HH, Lewis MA, Shi Q, et al. Prognostic impact of body mass index stratified by smoking status in patients with esophageal adenocarcinoma. J Clin Oncol, 2011, 29(34): 4561-4567.
13.	La Rosette JJ, Opondo D, Daels FP, et al. Categorisation of compli-cations and validation of the Clavien score for percutaneous neph-rolithotomy. Eur Urol, 2012, 62(2): 246-255.
14.	Monteiro E, Sklar MC, Eskander A, et al. Assessment of the Clavien-Dindo classification system for complications in head and neck surgery. Laryngoscope, 2014, 124(12): 2726-2731.
15.	Panhofer P, Ferenc V, Schutz M, et al. Standardization of morbidity assessment in breast cancer surgery using the Clavien Dindo Classi-fication. Int J Surg, 2014, 12(4): 334-339.
16.	Rassweiler JJ, Rassweiler MC, Michel MS. Classification of comp-lications: is the Clavien-Dindo classification the gold standard? Eur Urol, 2012, 62(2): 256-260.
17.	朱学应, 陈浩, 高理锦, 等.体重指数与食管癌切除术后预后之间的关系.安徽医药, 2011, 15(3): 347-349.
18.	Zhang SS, Yang H, Luo KJ, et al. The impact of body mass index on complication and survival in resected oesophageal cancer: a clinical-based cohort and meta-analysis. Br J Cancer, 2013, 109(11): 2894-2903.

1. Blom RL, Lagarde SM, Klinkenbijl JH, et al. A high body mass index in esophageal cancer patients does not influence postoperative outcome or long-term survival. Ann Surg Oncol, 2012, 19(3): 766-771.
2. Healy LA, Ryan AM, Gopinath B, et al. Impact of obesity on outcomes in the management of localized adenocarcinoma of the esophagus and esophagogastric junction. J Thorac Cardiovasc Surg, 2007, 134(5): 1284-1291.
3. Miao L, Chen H, Xiang J, et al. A high body mass index in esopha-geal cancer patients is not associated with adverse outcomes follo-wing esophagectomy. J Cancer Res Clin Oncol, 2015, 141(45): 941-950.
4. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg, 2004, 240(2): 205-213.
5. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin, 2011, 61(2): 69-90.
6. Holscher AH, Vallbohmer D, Brabender J. The prevention and management of perioperative complications. Best Pract Res Clin Gastroenterol, 2006, 20(5): 907-923.
7. Markar SR, Karthikesalingam A, Low DE. Outcomes assessment of the surgical management of esophageal cancer in younger and older patients. Ann Thorac Surg, 2012, 94(45): 1652-1658.
8. Scarpa M, Cagol M, Bettini S, et al. Overweight patients operated on for cancer of the esophagus survive longer than normal-weight patients. J Gastrointest Surg, 2013, 17(2): 218-227.
9. Scipione CN, Chang AC, Pickens A, et al. Transhiatal esophagectomy in the profoundly obese: implications and experience. Ann Thorac Surg, 2007, 84(2): 376-383.
10. Rustgi AK, El-Serag HB. Esophageal carcinoma. N Engl J Med, 2014, 371(26): 2499-2509.
11. Hayashi Y, Correa AM, Hofstetter WL, et al. The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy. Cancer, 2010, 116(24): 5619-5627.
12. Yoon HH, Lewis MA, Shi Q, et al. Prognostic impact of body mass index stratified by smoking status in patients with esophageal adenocarcinoma. J Clin Oncol, 2011, 29(34): 4561-4567.
13. La Rosette JJ, Opondo D, Daels FP, et al. Categorisation of compli-cations and validation of the Clavien score for percutaneous neph-rolithotomy. Eur Urol, 2012, 62(2): 246-255.
14. Monteiro E, Sklar MC, Eskander A, et al. Assessment of the Clavien-Dindo classification system for complications in head and neck surgery. Laryngoscope, 2014, 124(12): 2726-2731.
15. Panhofer P, Ferenc V, Schutz M, et al. Standardization of morbidity assessment in breast cancer surgery using the Clavien Dindo Classi-fication. Int J Surg, 2014, 12(4): 334-339.
16. Rassweiler JJ, Rassweiler MC, Michel MS. Classification of comp-lications: is the Clavien-Dindo classification the gold standard? Eur Urol, 2012, 62(2): 256-260.
17. 朱学应, 陈浩, 高理锦, 等.体重指数与食管癌切除术后预后之间的关系.安徽医药, 2011, 15(3): 347-349.
18. Zhang SS, Yang H, Luo KJ, et al. The impact of body mass index on complication and survival in resected oesophageal cancer: a clinical-based cohort and meta-analysis. Br J Cancer, 2013, 109(11): 2894-2903.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Effect of Body Mass Index on Short-term Outcome in Patients underwent Esophagectomy

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