Lee JH, et al. - The tie-up between body mass index (BMI) and mortality was comprehensively analyzed in patients with gastric cancer undergoing curative gastrectomy between October 2000 and June 2016. In patients undergoing curative gastric cancer surgery, better overall survival (OS) and disease-specific survival (DSS) was reported among those who were overweight or mildly-to-moderately obese (BMI 23 to < 30 kg/m²) preoperatively compared to normal-weight patients.

Methods

• A categorization was performed of 7,765 patients with gastric cancer undergoing curative gastrectomy between October 2000 and June 2016 into 6 groups based on BMI: Underweight (< 18.5 kg/m²), normal (18.5 to < 23 kg/m²), overweight (23 to < 25 kg/m²), mildly obese (25 to < 28 kg/m²), moderately obese (28 to < 30 kg/m²), and severely obese (≥ 30 kg/m²).
• Cox proportional hazard models assisted in the estimation of hazard ratios (HRs) for overall survival (OS) and disease-specific survival (DSS).

Results

• Among 7,765 patients, 1,279 (16.5%) all-cause and 763 (9.8%) disease-specific deaths were determined over 83.05 months (range 1.02-186.97) median follow-up.
• As per the multivariable analyses adjusted for statistically significant clinicopathological characteristics, preoperative BMI exhibited a connection with OS in a non-linear pattern.
• In contrast with normal-weight patients, underweight patients presented with worse OS [HR 1.42; 95% confidence interval (CI) 1.15-1.77].
• On the other hand, overweight (HR 0.84; 95% CI 0.73–0.97), mildly obese (HR 0.77; 95% CI 0.66-0.90), and moderately obese (HR 0.77; 95% CI 0.59-1.01) patients demonstrated better OS.
• A similar pattern was illustrated by DSS, displaying lowest mortality in moderately obese patients (HR 0.58; 95% CI 0.39-0.85).
• Lowest all-cause mortality risk at a BMI of 26.67 kg/m² was obtained in the Spline analysis.