Overweight or Obesity is an Unfavorable Long-Term Prognostic Factor for Patients who Underwent Gastrectomy for Stage II/III Gastric Cancer

BackgroundObesity has been reported to be a prognostic factor for many diseases in epidemiological studies; however, the results of studies examining the relationship between obesity and gastric cancer (GC) prognosis are inconsistent.MethodsA total of 460 patients with Stage II and III GC who underwent open R0 gastrectomy were included. Age, sex, body mass index (BMI classified into<18.5, 18.5-25, and25kg/m(2)), stage, and postoperative adjuvant chemotherapy were analyzed to investigate the correlation with relapse-free survival (RFS).ResultsFive-year RFS was 51% for the study patients. Five-year RFS values were 47.6%, 54.3%, and 40.1% for patients with BMI<18.5, 18.5-25, and25kg/m(2), respectively. The forest plot for relapse risk according to BMI showed a U shape. Multivariate analysis for RFS showed significant differences in stage and BMI; the hazard ratio for recurrence in patients with BMI25kg/m(2) was 1.42 (95% confidence interval: 1.01-2.02, p=0.0423) with reference to patients with BMI<25kg/m(2). BMI25.0 was associated with longer operation times, more blood loss, fewer lymph nodes dissected, more frequent postoperative surgical site infection, and intra-abdominal abscesses.ConclusionsBMI25kg/m(2) is an unfavorable prognostic factor for patients who underwent gastrectomy for Stage II and III GC.