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Does body mass index impact the number of LNs harvested and influence long-term survival rate in patients with stage III colon cancer?

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Abstract

Background

The aim of this study is to evaluate whether different body mass index (BMI) values affect lymph node (LN) retrieval and whether such variations influence long–term survival in Asian patients.

Method

From January 1995 to July 2003, 645 stage III colon cancer patients were enrolled in our study. Patients were stratified into four groups: Obese (BMI ≧ 27 kg/m2), overweight (24 ≤ BMI < 27 kg/m2), normal (18.5 ≤ BMI < 24 kg/m2), and underweight (BMI < 18.5 kg/m2).

Results

Mean BMI in the cohort was 23.3 kg/m2. Mean number of LNs harvested was 23.1, 19.5, 19.8 and 28.1 in the normal, overweight, obese and underweight groups, respectively. There was a significant difference in the mean number of LNs harvested when comparing the overweight and underweight groups to the normal group (p = 0.013 and p = 0.04, respectively). Females were overrepresented in the underweight group (p = 0.011), and patients who had proximal colon cancers were more frequently underweight (p = 0.018). The mean number of LNs harvested varied by cases of right hemicolectomy (p = 0.009) and proximal cancer location (p = 0.009) for different BMI groups. Multivariate analysis showed that underweight, proximal colon cancer, well- or moderately differentiated adenocarcinoma and stage IIIC cancer were significant variables for adequate LN recovery. BMI was not significantly associated with relapse-free survival (p = 0.523) or overall survival (p = 0.127).

Conclusion

BMI is associated with LN harvest but is not an independent variable in stage III colon cancer survival.

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Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, Chang Gung Memorial Hospital, 6 West Chia-Pu Road, Putz City, Chiayi, 61363, Taiwan, Republic of China

    Yi-Hung Kuo, Chih-Chien Chin, Wen-Shih Huang & Chung-Hung Yeh

  2. Graduate Institute of Clinical Medical Science, Chang Gung University, Taoyuan, 33305, Taiwan, Republic of China

    Chih-Chien Chin, Wen-Shih Huang & Jeng-Yi Wang

  3. Department of Pathology, Chang Gung Memorial Hospital, 6 West Chia-Pu Road, Putz City, Chiayi, 61363, Taiwan, Republic of China

    Kam-Fai Lee

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  1. Yi-Hung Kuo
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  2. Kam-Fai Lee
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Corresponding author

Correspondence to Chih-Chien Chin.

Additional information

Kuo YH and Lee KF contributed equally to this work; Kuo YH designed the report and provided discussion of the literatures; and Lee KF provided the discussion of the clinical cases and review of pathology. Dr. Kuo and Dr. Lee are co-first authors of the manuscript.

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Kuo, YH., Lee, KF., Chin, CC. et al. Does body mass index impact the number of LNs harvested and influence long-term survival rate in patients with stage III colon cancer?. Int J Colorectal Dis 27, 1625–1635 (2012). https://doi.org/10.1007/s00384-012-1496-5

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  • DOI: https://doi.org/10.1007/s00384-012-1496-5

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