The association between body mass index and postoperative complications, 30-day mortality and long-term survival in Dutch patients with colorectal cancer |
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| Institution: | 1. Division of Surgical Oncology, Radboud University Medical Centre, Geert Groteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands;2. Division of Research, Netherlands Comprehensive Cancer Organization (IKNL), Postbus 19079, 3501 DB, Utrecht, the Netherlands;3. Division of Public Health, Erasmus MC University Medical Centre, Wytemaweg 80, 3015 CN, Rotterdam, the Netherlands;4. Division of Surgery, Catharina Hospital, Postbus 1350, 5602 ZA, Eindhoven, the Netherlands;5. Division of Surgery, Elisabeth – TweeSteden Hospital, Doctor Deelenlaan 5, 5042 AD, Tilburg, the Netherlands;1. University Hospital Aintree, Longmoor Lane, Liverpool, Merseyside, L97AL, UK;2. Department of Biostatistics, University of Liverpool, Liverpool, Merseyside, L697ZX, UK;3. Aintree University Hospital, UK;1. Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, 8036, Graz, Austria;2. Comprehensive Cancer Centre Graz, Graz, Austria;3. Department of Orthopaedic Surgery, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands;4. Division of Oncology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria;5. Department of Experimental Therapeutics, The UT MD Anderson Cancer Center, Sout Campus Research Building 4, 1901 East Road, Houston, TX, USA;6. Division of Thoracic and Hyperbaric Surgery, Medical University of Graz, Auenbruggerplatz 29, 8036, Austria;7. Institute of Pathology, Medical University of Graz, Auenbruggerplatz 25, 8036, Graz, Austria;8. Department of Medical Statistics and Bioinformatics, Leiden University Medical Centre, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands;9. Mathematical Institute Leiden University, Albinusdreef 2, 2333 ZA, Leiden, The Netherlands;1. Department of Pancreatic Surgery, Huashan Hospital, Fudan University, Shanghai, 200040, China;2. Department of Plastic & Reconstructive Surgery, Shanghai Ninth People''s Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, 200011, China;1. Department of Visceral, Transplantation and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria;2. Department of Surgery, Paracelsus Medical University, Salzburg, Austria;3. Institute of Pathology, Paracelsus Medical University, Salzburg, Austria;4. Department of Surgery, Medical University Graz, Graz, Austria;5. Department of Surgery, Elisabethinen Hospital, Linz, Austria;6. Department of Surgery, Kaiser Franz Josef Hospital, Vienna, Austria;7. Department of Surgery, Hospital Sisters of Mercy Linz, Linz, Austria;8. Department of Surgery, General Hospital Horn, Horn, Austria;9. Department of Internal Medicine I, Paracelsus Medical University, Salzburg, Austria;10. Department of Surgery, General Hospital Dornbirn, Dornbirn, Austria;1. Department of Head and Neck Surgery and Oncology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands;2. Department of Epidemiology and Biostatistics at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands;3. Department of Pathology at the Netherlands Cancer Institute-Antoni van Leeuwenhoek, Plesmanlaan 121, NL-1066 CX Amsterdam, the Netherlands |
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| Abstract: | IntroductionThis retrospective study aims to examine the association between body mass index (BMI) and serious postoperative complications, 30-day mortality and overall survival in colorectal cancer (CRC) patients.Materials and methodsAll CRC patients diagnosed between 2008 and 2013 in the south-eastern part of the Netherlands were included. Patients were categorized into four BMI groups: underweight (<18.5), normal weight (18.5 ≥ BMI<25), overweight (25 ≥ BMI<30), and obese (≥30).ResultsA total of 7371 CRC patients were included (underweight 133 (1.8%); normal weight 2054 (41.4%); overweight 2955 (40.1%); obesity 1229 (16.7%)). Underweight patients were more likely to have postoperative complications (18.8% vs. 11.7%, adjusted OR 1.95, 95% CI 1.08–3.49) and had a worse 30-day mortality (9.8% vs. 3.3%, adjusted OR 4.37, 95% CI 2.03–9.42) compared to normal weight patients. After stratification for stage (stage I-III and stage IV), underweight was associated with a worse overall survival in both groups compared to normal weight (stage I-III: HR 2.06, 95%CI 1.51–2.80; stage IV: HR 1.65, 95% CI 1.11–2.45). Overweight was associated with an improved overall survival compared to normal weight in both stage groups. Only in stage IV patients obesity was associated with a significant better overall survival compared to stage IV normal weight patients.ConclusionUnderweight CRC patients were more likely to have postoperative complications and a worse 30-day mortality compared to patients in other BMI categories. The underweight population also has a worse long-term survival while overweight CRC patients and obese stage IV CRC patients were associated with an improved survival compared to normal weight patients. |
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| Keywords: | Colorectal cancer Body mass index Survival Postoperative complications Mortality |
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