Obesity in Patients with Gastric Cancer is Associated with More Postoperative Complications

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(ChemotherapyAdvisor) – Overweight patients with gastric cancer are less likely to have adequate lymph node staging and are more likely to suffer postoperative complications like wound infection and anastomotic leak, according to a study published in Annals of Surgical Oncology.

“Increased BMI (body mass index) is a predictor of increased postoperative complications, including anastomotic leak, but it is not a predictor of survival in gastric cancer,” reported senior author Vivian E. Strong, MD, of the Memorial Sloan-Kettering Cancer Center in New York, New York, and coauthors.

The authors studied the medical records of 1,853 patients who had undergone gastric carcinoma resection between 1985 and 2007. Of these, 1,125 patients (60.7%) were overweight (BMI ≥ 25 kg/m2).

BMI ≥ 25 was associated with a higher percentage of patients experiencing postoperative complications than BMI < 25 (47.9% vs. 35.8%; P<0.001). Overweight patients' increased rates of surgical site infections (8.9% vs. 4.7%; P=0.02) and anastomotic leaks (11.8% vs. 5.4%; P=0.002) were largely responsible for the overall association, the authors noted. Neoadjuvant chemotherapy was also associated with increased rates of wound infection and anastomotic leak.

“Overweight patients were less likely to have adequate lymph node staging (73.3 vs. 79.2%, P=0.047),” the authors noted. “Excessive abdominal fat can hinder surgical retrieval of lymph nodes located deep in adipose tissue around major vessels and can even impair pathologic identification from the resected specimen.”

Adequate staging requires pathologic assessment of ≥15 nodes with gastrectomy specimen, the authors noted.

OS (overall survival) and DSS (disease-specific survival) rates were not significantly different between overweight and other patients with gastric cancer, they reported.

Abstract

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