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Prognostic Impact of Body Mass Index in Patients with Squamous Cell Carcinoma of the Esophagus

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To clarify the prognostic impact of body mass index (BMI) in patients with esophageal squamous cell carcinoma (ESCC).

Methods

Two hundred forty-three patients who underwent esophagectomy for ESCC from April 2005 through December 2010 were eligible. Prognoses of the patients were compared between groups stratified according to BMI. We also analyzed the survival difference using propensity score matching to adjust differences in staging and treatment.

Results

Low, normal, and high BMI groups had 35, 177, and 31 patients, respectively. The low BMI group included more advanced cases than did the normal BMI group, while tumor stage was equivalent in the normal and high BMI groups. Disease-free survival of the low and high BMI groups was significantly worse than that of the normal BMI group (P < 0.0001 between the low and normal BMI groups; P = 0.0076 between the normal and high BMI groups). Disease-free survival of the high BMI group was significantly worse than that of the normal BMI group in the propensity score-matched cohort (P = 0.0020). Multivariate analysis in this cohort demonstrated that high BMI was an independent prognostic factor (hazard ratio 2.949, 95 % confidence interval, 1.132–7.683).

Conclusions

High BMI was an independent prognostic factor after curative esophagectomy for ESCC. Although further analysis is required to clarify the influence of overweight on the biological features of ESCC, glucose metabolism may be a therapeutic target for ESCC.

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Conflict of interest

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Gastroenterological Surgery, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan

    Masayuki Watanabe MD, PhD, FACS, Takatsugu Ishimoto MD, PhD, Yoshifumi Baba MD, PhD, Yohei Nagai MD, PhD, Naoya Yoshida MD, PhD & Hideo Baba MD, PhD, FACS

  2. Research Center for Innovative Oncology, National Cancer Center Hospital East, Chiba, Japan

    Takeharu Yamanaka PhD

Authors
  1. Masayuki Watanabe MD, PhD, FACS
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  2. Takatsugu Ishimoto MD, PhD
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  3. Yoshifumi Baba MD, PhD
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  4. Yohei Nagai MD, PhD
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  5. Naoya Yoshida MD, PhD
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  6. Takeharu Yamanaka PhD
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  7. Hideo Baba MD, PhD, FACS
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Corresponding author

Correspondence to Masayuki Watanabe MD, PhD, FACS.

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Fig. 1

Changes in BMIs during preoperative treatment. Significant decrease in BMI was observed in patients who underwent definitive chemoradiotherapy (P=0.0098, paired t-test). NAC, Neoadjuvant chemotherapy; NACRT, Neoadjuvant chemoradiotherapy; dCRT, Definitive chemoradiotherapy. (PDF 86 kb)

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Watanabe, M., Ishimoto, T., Baba, Y. et al. Prognostic Impact of Body Mass Index in Patients with Squamous Cell Carcinoma of the Esophagus. Ann Surg Oncol 20, 3984–3991 (2013). https://doi.org/10.1245/s10434-013-3073-8

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  • DOI: https://doi.org/10.1245/s10434-013-3073-8

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