Effect Of Preoperative BMI On Total Survival After Surgical Resection In Patients With Stage ?A Non-small Cell Lung Cancer

Background The BMI is a figure obtained by dividing the weight in kilograms by the square of the height of the square meter.It is a common standard used in the world to measure the fatness and health of the human body.According to the standards specified by the National Health and Family Planning Commission of the People's Republic of China,the following classifications can be made:standard BMI 18.5-23.9,overweight BMI 24 to27.9,obesity BMI?28.Demographic studies have shown that high body mass index(BMI)is associated with a reduced risk of lung cancer death.Specifically,severe obesity(BMI?40)is generally considered to increase mortality in all cancers,which made male and female mortality rates improving by 52%and 62%.However,the relationship between high BMI and high cancer mortality is not consistent between different types of cancer.Obesity can increase the mortality of gastrointestinal malignancies(esophagus,stomach,gallbladder,pancreas,colon),prostate cancer and breast cancer,but obese individuals who suffer with renal cell carcinoma,diffuse large B cells,lymphoma and Lung cancer is negatively correlated.Especially in lung cancer,the relationship between BMI index and lung cancer still needs further study.Lung cancer is the most common malignant tumor in the world.The purpose of this study was to evaluate the effect of BMI on the overall survival of patients with non-small cell lung cancer.Methods Department of Thoracic Surgery,Affiliated Hospital of Qingdao University From January 2013 to December 2013,a total of 1131 patients with non-small cell lung cancer were enrolled.According to relevant standrad,138 patients with stage ?A non-small cell lung cancer were screened.According to the telephone follow-up(in our hospital,we recorded the patient's own phone number and at least one patient's family phone),21 people lost contact.So,the final study population is 117 patients with stage ?A non-small cell lung cancer that be used for statistical analysis.Then,we collect basic information such as patient BMI and disease treatment relevant feature information.COX regression analysis was used to identify variable factors associated with overall survival.Results According to the Kaplan-Meier survival analysis of 117 patients in our hospital,the OS of patients with normal BMI 18.5-23.9,overweight BMI 24~27.9,and obeseBMI?28 were different(c~2=9.510,P=0.009).In univariate analysis,both overweight and obese improved OS in patients(overweight,OR=0.538,95%CI:0.305-0.952,P=0.033;obese,OR=0.335,95%CI:0.157-0.712,P=0.004).Factors negatively associated with OS included postoperative lung cancer pathology such as squamous cell carcinoma(OR=1.884,95%CI:1.030-3.449,P=0.040),smokers(OR=2.836,95%CI:1.634-4.923,P<0.001),and male patients.(OR=1.749,95%CI:1.291-2.369,P<0.001).In the multivariate Cox regression model,the increase in BMI index was still an independent predictor of overall survival,and both overweight and obese improved OS in patients(overweight,OR=0.393,95%CI:0.212-0.728,P=0.006);(obese,OR=0.419,95%CI:0.186-0.941,P=0.035).Conclusion In this study,a higher BMI could improved the survival of patients with stage ?A non-small cell lung cancer when the relevant variables were controlled.However,further research is necessary to clarify the further relationship between the BMI and the prognosis of the disease.