Body Mass Index Layered To Analyse The Effect On Postoperative Outcomes In Patient With Gastric Cancers

Objective To explore the short-term prognosis and survival rate of body mass index on postoperative gastric cancer patients.Methods Retrospective analysis the clinical and follow-up date of 153 cases with gastric radical abdominal in our hospital in the first half of 2010. According to body mass index(BMI), the patients were divided into low weight group(BMI<18.5), the normal weight group(18.5≤BMI<25) and overweight or obese group(BMI≥25). Comparison between the three groups of years, operation time, intraoperative blood loss, the numbers of lymph nodes retrieved, postoperative hospitalization days, preoperative hemoglobin, preoperative albumin, the 5-year survival period, overall survive time, tumor location, tumor stage, lymph node metastasis rate and postoperative complication, and to analysis the single factors and multiple factors which affect overall survival.Results The preoperative hemoglobin is(106±13.8) g/L in low weight group, obviously low to the normal group and overweight or obese group which are(113.5±13.8) g/L and(123.5±8.7) g/L, and the different is statistically significant(F=3.265, P=0.041). The preoperative albumin in low group is(38.7±2.5) g/L, obviously low to the other two groups as well which are(41.3±0.8) g/L and(43.5±1.4) g/L, the different is also statistically significant(F=8.516, P=0.000). The rate of cardiac cancers in low weight group is relatively inferior to other groups [34.8%(8/23) inferior to 68.4%(65/95) and 62.9%(22/35), х2 =8.913, P=0.012]. Among the three groups, the differences of ages, operation time, intraoperative blood loss, the numbers of lymph nodes retrieved, lymph node metastasis rate, tumor stage, postoperative complication and postoperative hospitalization days are not statistically significant(all P>0.05). The 5-year survival rate are 43.5%, 50.5% and 65.7% respectively and have no statistically different(P=0.189). Further subgroup analysis according to tumor location and BMI, the result is that the 5-year survival rate of low weight group in the non-cardiac group is significantly inferior to obesity or obese group in the cardiac group and were statistically significant(25.0% compare 84.6%, P=0.004). Survival analysis results suggest the long-term survival of patients with gastric cancer relate to tumor stage(P=0.000/0.000), lymph node metastasis(P=0.000/0.000) and preoperative albumin(P=0.000/0.001). Among them, tumor stage(P=0.000) and preoperative albumin(P=0.040) are the independent factors influencing long-term survival of patients with stomach cancer. The long-term survival of patients with gastric cancer have no statistically significant difference to BMI(P=0.283/0.422), age(P=0.180/0.106) and preoperative albumin(P=0.454/0.491). In addition, the overall survival of low weight group in the non-cardiac group is significantly inferior to obesity or obese group in the cardiac group(P=0.004/0.007).Conclusion Generally speaking, BMI did not affect the gastric cancer patients on the short-term prognosis and long survival, but scaling up nutrition and keep a normal BMI may have some benefits to long term survival in lower body mass people especially in non-cardiac cancers.