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Impact of Body Mass Index on Surgical Outcomes after Esophagectomy for Patients with Esophageal Squamous Cell Carcinoma.
[esophageal squamous cell carcinoma]
Patients
with
overweight
reportedly
have
more
comorbidities
,
including
diabetes
mellitus
and
cardiovascular
disease
,
and
longer
operating
times
as
well
as
more
blood
loss
during
surgery
compared
with
those
with
normal
weight
.
However
,
the
impact
of
overweight
on
the
short
-term
outcome
after
transthoracic
esophagectomy
for
patients
with
esophageal
squamous
cell
carcinoma
(
ESCC
)
remains
unclear
.
We
hypothesized
that
overweight
has
a
negative
impact
on
short
-term
surgical
outcomes
after
esophagectomy
for
patients
with
ESCC
.
A
total
of
304
patients
who
underwent
transthoracic
esophagectomy
for
ESCC
were
included
in
this
study
.
Body
mass
index
(
BMI
)
was
classified
into
three
categories
,
<
18
.
49
,
18
.
50
-
24
.
99
,
and
>
25
.
00
(
kg
/
m
(
2
)
)
,
defined
as
low
,
normal
,
and
high
BMI
,
respectively
,
according
to
the
World
Health
Organization
criteria
.
We
investigated
the
association
of
BMI
status
with
patient
demographics
and
surgical
outcomes
after
esophagectomy
for
patients
with
ESCC
.
In
addition
,
overall
survival
and
relapse-free
survival
stratified
by
BMI
were
compared
.
Fifty
-
nine
(
19
.
4
Â
%
)
and
41
(
13
.
4
Â
%
)
patients
were
classified
to
low
BMI
and
high
BMI
,
respectively
.
The
high
-
BMI
group
had
significantly
higher
comorbidity
rates
of
diabetes
mellitus
(
p
 
<
 
0
.
01
)
and
anastomotic
leakage
(
p
 
=
 
0
.
011
)
than
the
normal-
BMI
group
.
There
were
no
significant
association
between
high
BMI
and
another
various
complications
except
for
an
anastomotic
leakage
,
severe
complications
defined
by
Clavien-
Dindo
classification
and
in
-hospital
mortality
.
In
multivariate
analysis
,
high
BMI
was
a
significant
risk
factor
for
anastomotic
leakage
(
p
 
=
 
0
.
030
,
hazard
ratio
;
3
.
423
,
95
%
CI
;
1
.
128
-
10
.
38
)
.
On
the
other
hand
,
no
significant
association
was
observed
between
low
BMI
and
short
surgical
outcomes
.
There
were
no
significant
differences
in
overall
and
relapse-free
survival
among
the
three
BMI
groups
in
univariate
and
multivariate
analysis
(
p
 
=
 
0
.
128
and
p
 
=
 
0
.
584
,
respectively
)
.
The
surgical
treatment
should
not
be
denied
for
patients
with
ESCC
due
to
overweight
and
underweight
.
However
,
intraoperative
prevention
and
postoperative
careful
monitoring
for
anastomotic
leakage
might
be
required
after
esophagectomy
for
overweight
patients
with
ESCC
.
Diseases
Validation
Diseases presenting
"diabetes mellitus"
symptom
acute rheumatic fever
adrenal incidentaloma
adrenomyeloneuropathy
allergic bronchopulmonary aspergillosis
alpha-thalassemia
child syndrome
cholangiocarcinoma
cohen syndrome
congenital adrenal hyperplasia
congenital toxoplasmosis
cowden syndrome
cushing syndrome
cystinuria
esophageal adenocarcinoma
esophageal carcinoma
esophageal squamous cell carcinoma
fabry disease
familial hypocalciuric hypercalcemia
malignant atrophic papulosis
neuralgic amyotrophy
pyomyositis
sneddon syndrome
typhoid
werner syndrome
wolf-hirschhorn syndrome
This symptom has already been validated