Annals of Surgical Oncology

, Volume 20, Issue 3, pp 780–787 | Cite as

Impact of Obesity on Perioperative Complications and Long-term Survival of Patients with Gastric Cancer

  • Kai A. Bickenbach
  • Brian Denton
  • Mithat Gonen
  • Murray F. Brennan
  • Daniel G. Coit
  • Vivian E. StrongEmail author
Gastrointestinal Oncology



The prevalence of obesity is increasing in the United States. Obesity has been associated with worse surgical outcomes, but its impact on long-term outcomes in gastric cancer is unclear. The aim of this study was to evaluate the effects of being overweight on surgical and long-term outcomes for patients with gastric cancer.


Patients who underwent curative intent resection for gastric carcinoma from 1985 to 2007 were identified from a prospectively collected gastric cancer database. Overweight was defined as a body mass index (BMI) of 25 kg/m2 or higher. Clinical outcomes of overweight and nonoverweight patients were compared.


From the total population of 1,853 patients, 1,125 (60.7 %) were overweight. Overweight patients tended to have more proximal tumors and a lower T stage. Accurate complication data were available on a subset of patients from 2000 to 2007. A BMI of ≥25 was associated with increased postoperative complications (47.9 vs. 35.8 %, p < 0.001). This was mainly due to an increase in the rate of wound infections (8.9 vs. 4.7 %, p = 0.02) and anastomotic leaks (11.8 vs. 5.4 %, p = 0.002). Multivariate logistic regression analysis showed that higher BMI, total gastrectomy, and use of neoadjuvant chemotherapy were associated with increased wound infection and anastomotic leak. Overweight patients were less likely to have adequate lymph node staging (73.3 vs. 79.2 %, p = 0.047). There was no difference in overall survival or disease-specific survival between the two groups.


Increased BMI is a predictor of increased postoperative complications, including anastomotic leak, but it is not a predictor of survival in gastric cancer.


Body Mass Index Gastric Cancer Overall Survival Anastomotic Leak High Body Mass Index 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflicts of interest

There is no conflicts of interest.


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Copyright information

© Society of Surgical Oncology 2012

Authors and Affiliations

  • Kai A. Bickenbach
    • 1
  • Brian Denton
    • 2
  • Mithat Gonen
    • 2
  • Murray F. Brennan
    • 1
  • Daniel G. Coit
    • 1
  • Vivian E. Strong
    • 1
    Email author
  1. 1.Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  2. 2.Department of Epidemiology and BiostatisticsMemorial Sloan-Kettering Cancer CenterNew YorkUSA

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