PMID- 22150920
OWN - NLM
STAT- MEDLINE
DCOM- 20130213
LR  - 20190221
IS  - 1442-2050 (Electronic)
IS  - 1120-8694 (Linking)
VI  - 25
IP  - 7
DP  - 2012 Sep-Oct
TI  - Patients with high body mass index tend to have lower stage of esophageal 
      carcinoma at diagnosis.
PG  - 614-22
LID - 10.1111/j.1442-2050.2011.01290.x [doi]
AB  - High body mass index (H-BMI; >/=25 kg/m(2) ) is common in US adults. In a small 
      cohort of esophageal cancer (EC) patients treated with surgery, H-BMI and 
      diagnosis of early stage EC appeared associated. We evaluated a much larger 
      cohort of EC patients. From a prospectively maintained database, we analyzed 925 
      EC patients who had surgery with or without adjunctive therapy. Various 
      statistical methods were used. Among 925 patients, 69% had H-BMI, and 31% had 
      normal body mass index (<25 kg/m(2) ; N-BMI). H-BMI was associated with men 
      (P<0.001), Caucasians (P=0.064; trend), lower esophageal localization (P<0.001), 
      adenocarcinoma histology (P<0.001), low baseline cT-stage (P=0.003), low baseline 
      overall clinical stage (P=0.003), coronary artery disease (P=0.036), and diabetes 
      (P<0.001). N-BMI was associated with weight loss (P<0.001), alcohol abuse 
      (P=0.056; trend), ever/current smoking (P=0.014), and baseline cN+ (P=0.018). 
      H-BMI patients with cT1 tumors (n=110) had significantly higher rates of 
      gastresophageal reflux disease symptoms (P<0.001), gastresophageal reflux disease 
      history (P<0.001), and Barrett's esophagus history (P<0.001) compared with H-BMI 
      patients with cT2 tumors (n=114). Median survival of N-BMI patients was 36.66 
      months compared with 53.20 months for H-BMI patients (P=0.005). In multivariate 
      analysis, older age (P<0.001), squamous histology (P=0.002), smoking (P=0.040), 
      weight loss (P=0.002), high baseline stage (P<0.001), high number of ypN+ 
      (P=0.005), high surgical stage (P<0.001), and American Society of Anesthesia 
      scores, three out of four (P<0.001) were independent prognosticators for poor 
      overall survival. We were able to perform propensity-based analysis of surgical 
      complications between H-BMI and N-BMI patients. A comparison of fully matched 376 
      patients (188 with H-BMI and 188 with N-BMI) found no significant differences in 
      the rate of complications between the two groups. This larger data set confirms 
      that a fraction of H-BMI patients with antecedent history is diagnosed with early 
      baseline EC. Upon validation of our data in an independent cohort, refinements in 
      surveillance of symptomatic H-BMI patients are warranted and could be 
      implemented. Our data also suggest that H-BMI patients do not experience higher 
      rate of surgical complications compared with N-BMI patients.
CI  - (c) 2011 Copyright the Authors. Journal compilation (c) 2011, Wiley Periodicals, Inc. 
      and the International Society for Diseases of the Esophagus.
FAU - Hayashi, Y
AU  - Hayashi Y
AD  - Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson 
      Cancer Center, Houston, Texas 77030, USA.
FAU - Correa, A M
AU  - Correa AM
FAU - Hofstetter, W L
AU  - Hofstetter WL
FAU - Vaporciyan, A A
AU  - Vaporciyan AA
FAU - Mehran, R J
AU  - Mehran RJ
FAU - Rice, D C
AU  - Rice DC
FAU - Suzuki, A
AU  - Suzuki A
FAU - Lee, J H
AU  - Lee JH
FAU - Bhutani, M S
AU  - Bhutani MS
FAU - Welsh, J
AU  - Welsh J
FAU - Lin, S H
AU  - Lin SH
FAU - Maru, D M
AU  - Maru DM
FAU - Swisher, S G
AU  - Swisher SG
FAU - Ajani, J A
AU  - Ajani JA
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20111209
PL  - United States
TA  - Dis Esophagus
JT  - Diseases of the esophagus : official journal of the International Society for 
      Diseases of the Esophagus
JID - 8809160
SB  - IM
MH  - Adenocarcinoma/complications/*diagnosis/pathology
MH  - Age Factors
MH  - Aged
MH  - Body Mass Index
MH  - Carcinoma, Squamous Cell/complications/*diagnosis/pathology
MH  - Cohort Studies
MH  - Esophageal Neoplasms/complications/*diagnosis/pathology
MH  - Esophageal Squamous Cell Carcinoma
MH  - Female
MH  - Humans
MH  - Kaplan-Meier Estimate
MH  - Male
MH  - Middle Aged
MH  - Neoplasm Staging
MH  - Obesity/complications
MH  - Overweight/*complications
MH  - Retrospective Studies
MH  - Sex Factors
MH  - Survival Rate
MH  - Time Factors
EDAT- 2011/12/14 06:00
MHDA- 2013/02/14 06:00
CRDT- 2011/12/14 06:00
PHST- 2011/12/14 06:00 [entrez]
PHST- 2011/12/14 06:00 [pubmed]
PHST- 2013/02/14 06:00 [medline]
AID - 10.1111/j.1442-2050.2011.01290.x [doi]
PST - ppublish
SO  - Dis Esophagus. 2012 Sep-Oct;25(7):614-22. doi: 10.1111/j.1442-2050.2011.01290.x. 
      Epub 2011 Dec 9.