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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
"severe complications"
symptom
alpha-thalassemia
child syndrome
cutaneous mastocytosis
esophageal squamous cell carcinoma
fabry disease
familial mediterranean fever
kabuki syndrome
severe combined immunodeficiency
wiskott-aldrich syndrome
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