Influence of Overweight on Patients With Gastric Cancer After Undergoing Curative Gastrectomy An Analysis of 689 Consecutive Cases Managed by a Single Center

Hypothesis: Overweight ( body mass index [ calculated as weight in kilograms divided by height in meters squared], >= 25.0) has an effect on surgical results, postoperative complications, and long-term survival in patients with gastric cancer who underwent curative gastrectomy. Design: Retrospective study from January 1, 1992, through December 31, 2002. Setting: Wakayama Medical University Hospital. Patients: This study included 689 patients who underwent curative gastrectomy (R0). Patients who underwent laparoscopic gastrectomy, gastrectomy with pancreaticoduodenectomy, gastrectomy with another organ resection ( liver, colon, or ovary), or gastrectomy with thoracotomy were not included. Main Outcome Measures: Duration of operation, amount of blood loss, incidence of postoperative complications, and survival analysis. Results: The mean (SD) duration of the operation was longer in the overweight group ( 315 [ 75] minutes) than in the normal-weight group ( 277 [ 85] minutes) (P <. 001). The mean (SD) intraoperative blood loss was larger in the overweight group ( 882 [ 764] mL) than in the normal-weight group ( 536 [ 410] mL) (P <. 001). The rates of postoperative complications ( anastomotic leakage, pancreatic fistula, and intra-abdominal abscess) were significantly higher in the overweight group (P <. 05). Multivariate logistic regression analysis identified that postoperative complications were significantly associated with being overweight (P = .01) and with undergoing pancreatectomy (P =. 03). Disease-specific and overall survival did not show any significant difference between the 2 groups. Conclusions: Being overweight is not a poor risk factor for survival in patients with gastric cancer, although it is independently predictive of postoperative complications.