Impact of body mass index on lymph node dissection and surgical outcomes of patients with gastric cancer

15655 Background: There has been a general consensus that increased body mass index (BMI) is correlated with poor surgical outcome. The purpose of this study was to clarify the effects of BMI on surgical outcomes of gastric cancer patients. Methods: A total of 517 patients who underwent curative total gastrectomy with D2 dissection from January 2000 to December 2003 were studied retrospectively from a prospectively designed computer database. The patients were assigned to three groups according to their BMI: group A, BMI < 23 kg/m2 (normal and underweight); group B, BMI 23–24.9 kg/m2 (overweight); group C, BMI ≥ 25 kg/m2 (obesity). The parameters such as operation time, blood loss, packed RBC transfusion, number of retrieved lymph nodes, first time of flatus, start of soft diet, postoperative hospital stay, postoperative morbidity, mortality, recurrence, and prognosis were analyzed. Results: Group C patients had significant longer operation time and higher postoperative complications in comparison to group A and B. However, there were no significant differences regarding blood loss, packed RBC transfusion, number of retrieved lymph nodes, first time of flatus, start of soft diet, postoperative stay, mortality, recurrence, and survival rates among three groups. Logistic regression analysis revealed that tumor size, histological type, serosal invasion, and nodal metastasis were independent risk factors for recurrence while obesity was not. Multivariate analysis showed that age, tumor size, histological type, serosal invasion, and nodal metastasis were independent prognostic factors whereas obesity was not. Conclusions: Although BMI affect somewhat operation time and postoperative morbidity, it does not affect long-term outcomes of patients with gastric cancer. No significant financial relationships to disclose.