Overweight Patients Achieve Ideal Body Weight Following Curative Gastrectomy Resulting in Better Long-Term Prognosis

The relationship between body mass index (BMI) and long-term outcome in gastric cancer patients following radical gastrectomy continues to be debated. We investigated the association between BMI, clinicopathological features, and prognosis in Chinese gastric carcinoma patients. A retrospective consecutive cohort study was performed on 1,296 patients who underwent gastrectomy with curative intent at the Tianjin Cancer Institute Hospital between 1999 and 2004. The clinicopathological characteristics, overall 5-year survival rate (OS), and preoperative and six-month postoperative BMIs of both overweight (BMI a parts per thousand yen25 kg/m(2); H-BMI; n = 364) and non-overweight (BMI < 25 kg/m(2); N-BMI; n = 932) patients were compared. Among these patients, 364 (28.1 %) were overweight. The OS was significantly higher in the H-BMI than N-BMI group (33.2 vs. 24.1 %, respectively; p < 0.001). Preoperative and six-month postoperative BMIs were 27.1 +/- 2.0 and 24.8 +/- 2.0 kg/m(2), respectively, in the H-BMI group (p < 0.001), whereas they were 21.7 +/- 2.2 and 20.7 +/- 2.2 kg/m(2), respectively, in the N-BMI group (p = 0.007). There was significantly better differentiation (p = 0.034), less distant metastases (p = 0.006), and a lower metastatic lymph node ratio (p = 0.014) observed in the H-BMI groups. Multivariate analyses indicated age, BMI, pathological tumor depth, distant metastases, metastatic lymph node ratio, and tumor size as independent prognostic factors. Our findings suggest that overweight patients were less likely to have tumors with aggressive features and can achieve ideal body weight following curative gastrectomy, possibly resulting in better long-term prognosis.