Gut and Liver (Mar 2023)

Impact of Body Mass Index on Survival Depending on Sex in 14,688 Patients with Gastric Cancer in a Tertiary Hospital in South Korea

  • Hyeong Ho Jo,
  • Nayoung Kim,
  • Jieun Jang,
  • Yonghoon Choi,
  • Jaehyung Park,
  • Young Mi Park,
  • Soyeon Ahn,
  • Hyuk Yoon,
  • Cheol Min Shin,
  • Young Soo Park,
  • Dong Ho Lee,
  • Hyeon Jeong Oh,
  • Hye Seung Lee,
  • Young Suk Park,
  • Sang-Hoon Ahn,
  • Yun-Suhk Suh,
  • Do Joong Park,
  • Hyung Ho Kim,
  • Ji-Won Kim,
  • Jin Won Kim,
  • Keun-Wook Lee,
  • Won Chang,
  • Ji Hoon Park,
  • Yoon Jin Lee,
  • Kyoung Ho Lee,
  • Young Hoon Kim

DOI
https://doi.org/10.5009/gnl220104
Journal volume & issue
Vol. 17, no. 2
pp. 243 – 258

Abstract

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Background/Aims: The incidence and prognosis of gastric cancer (GC) shows sex difference. This study aimed to evaluate the effect of body mass index (BMI) on GC survival depending on sex. Methods: The sex, age, location, histology, TNM stages, BMI, and survival were analyzed in GC patients from May 2003 to February 2020 at the Seoul National University Bundang Hospital. Results: Among 14,688 patients, there were twice as many males (66.6%) as females (33.4%). However, under age 40 years, females (8.6%) were more prevalent than males (3.1%). Cardia GC in males showed a U-shaped distribution for underweight (9.6%), normal (6.4%), overweight (6.1%), obesity (5.6%), and severe obesity (9.3%) but not in females (p=0.003). Females showed decreased proportion of diffuse-type GC regarding BMI (underweight [59.9%], normal [56.8%], overweight [49.5%], obesity [44.8%], and severe obesity [41.7%]), but males did not (p<0.001). Both sexes had the worst prognosis in the underweight group (p<0.001), and the higher BMI, the better prognosis in males, but not females. Sex differences in prognosis according to BMI tended to be more prominent in males than in females in subgroup analysis of TNM stages I, II, and III and the operative treatment group. Conclusions: GC-specific survival was affected by BMI in a sex-dependent manner. These differences may be related to genetic, and environmental, hormonal factors; body composition; and muscle mass (Trial registration number: NCT04973631).

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