| Institution: | 1. Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea;2. Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea;3. Department of Internal Medicine, Konkuk University, Chungju, Republic of Korea;4. Department of Neuropsychiatry, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, Republic of Korea;1. Division of Surgical Oncology, Department of Surgery, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, United States;2. Center for Surgery and Public Health, Department of Surgery, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, United States;1. Department of Health and Nutrition, Tokaigakuen University, 2-901 Nakahira, Tempaku-ku, Nagoya-shi, Aichi-ken 468-0014, Japan;2. Department of Health and Social Behavior, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan;3. Department of Policy Studies, Aichi Gakuin University, 12 Araike, Iwasaki-cho, Nisshin-shi, Aichi-ken 470-0131, Japan;4. Graduate School of Dentistry, Tohoku University, 4-1 Seiryo-cho, Aoba-ku, Sendai-shi, Miyagi-ken 980-8575, Japan;5. Department of Community Health and Preventive Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu-shi, Shizuoka-ken 431-3192, Japan;6. Center for Well-being and Society, Nihon Fukushi University, 5-22-35 Chiyoda, Naka-ku, Nagoya-shi, Aichi-ken 460-0012, Japan;7. Center for Preventive Medical Science, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba-shi, Chiba-ken 260-8670, Japan;8. Department of Civil and Environmental Engineering, Iwate University, 4-3-5 Ueda, Morioka-shi, Iwate-ken 020-8551, Japan |
| Abstract: | BackgroundThe age-dependent survival impact of body mass index (BMI) remains to be fully addressed in patients with gastric carcinoma (GC). We investigated the prognostic impacts of BMI in elderly (≥70 years) and non-elderly patients undergoing surgery for GC.MethodsIn total, 1168 GC patients were retrospectively reviewed. Patients were stratified into 3 groups according to BMI; low (<20), medium (20–25) and high (>25). The effects of BMI on overall survival (OS) and cancer-specific survival (CSS) were assessed using univariate and multivariate Cox hazards models.ResultsThere were 242 (20.7%), 685 (58.7%) and 241 (20.6%) patients in the low-, medium- and high-BMI groups, respectively. The number of patients with high BMI but decreased muscle mass was extremely small (n = 13, 1.1%). Patients in the low-BMI group exhibited significantly poorer OS than those in the high- and medium-BMI group (P < 0.001). Notably, BMI classification significantly demarcated OS and CSS curves (both P < 0.001) in non-elderly patients, while did not in elderly patients (OS; P = 0.07, CSS; P = 0.54). Furthermore, the survival discriminability by BMI was greater in pStage II/III disease (P = 0.006) than in pStage I disease (P = 0.047). Multivariable analysis focusing on patients with pStage II/III disease showed low BMI to be independently associated with poor OS and CSS only in the non-elderly population.ConclusionsBMI-based evaluation was useful for predicting survival and oncological outcomes in non-elderly but not in elderly GC patients, especially in those with advanced GC. |
