Evaluating the role of BMI in survival and complications in older esophageal squamous cell carcinoma following esophagectomy.

IF 4 Q2 ONCOLOGY

Oncology Reviews Pub Date : 2026-02-23 eCollection Date: 2026-01-01 DOI:10.3389/or.2026.1757530

Kexun Li, Simiao Lu, Changding Li, Jie Mao, Huan Zhang, Kangning Wang, Guangyuan Liu, Yongtao Han, Lin Peng, Xuefeng Leng

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引用次数: 0

Abstract

Background: To evaluate the impact of Body Mass Index (BMI) on survival and postoperative complications in older patients with esophageal squamous cell carcinoma (ESCC) following esophagectomy, we designed this study.

Materials and methods: We retrospectively analyzed 469 patients aged ≥70 years with thoracic ESCC who underwent esophagectomy at Sichuan Cancer Hospital (May 2016-August 2021). Patients were grouped by WHO BMI categories: underweight (<18.5 kg/m²), normal (18.5-24.9 kg/m²), and overweight/obese (≥25 kg/m²). Primary outcomes were overall survival (OS) and disease-free survival (DFS); secondary outcomes included Clavien-Dindo grade III-IV complications. Kaplan-Meier, Cox models, and restricted cubic splines (RCS) were used.

Results: Median follow-up was 47.5 months; R0 resection was achieved in 96.4%. BMI distribution: 7.3% low, 76.8% normal, 16.0% high. Median OS was 44.9 months overall, with no significant OS or DFS differences among BMI groups. RCS demonstrated a significant U-shaped association between continuous BMI and survival: protective ranges were approximately 21.9-27.0 kg/m² for OS (P non-linearity = 0.014) and 20.2-27.2 kg/m² for DFS (P non-linearity = 0.033).

Conclusion: In elderly ESCC patients after esophagectomy, BMI does not independently influence OS or DFS, though low BMI is associated with specific serious complications. Perioperative optimization-particularly nutritional support for underweight patients-remains essential.

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评价BMI在食管切除术后老年食管鳞状细胞癌患者生存和并发症中的作用。

背景：为了评估体重指数（BMI）对食管切除术后老年食管鳞状细胞癌（ESCC）患者生存和术后并发症的影响，我们设计了本研究。材料和方法：我们回顾性分析2016年5月- 2021年8月在四川省肿瘤医院行食管切除术的469例年龄≥70岁的胸腔ESCC患者。患者按WHO BMI分类：体重过轻(2)、正常（18.5-24.9 kg/m2）和超重/肥胖（≥25 kg/m2）。主要结局是总生存期（OS）和无病生存期（DFS）；次要结局包括Clavien-Dindo III-IV级并发症。采用Kaplan-Meier模型、Cox模型和限制性三次样条（RCS）。结果：中位随访时间为47.5个月；R0切除率为96.4%。BMI分布：低7.3%，正常76.8%，高16.0%。总体中位OS为44.9个月，BMI组间OS和DFS无显著差异。RCS显示，连续BMI与生存率之间存在显著的u形关联：OS的保护范围约为21.9-27.0 kg/m2 (P非线性= 0.014)，DFS的保护范围约为20.2-27.2 kg/m2 （P非线性= 0.033）。结论：在食管切除术后的老年ESCC患者中，BMI不独立影响OS或DFS，尽管低BMI与特定的严重并发症相关。围手术期的优化——尤其是对体重过轻患者的营养支持——仍然至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Oncology Reviews ONCOLOGY-

CiteScore

6.30

自引率

0.00%

发文量

审稿时长

9 weeks

期刊介绍： Oncology Reviews is a quarterly peer-reviewed, international journal that publishes authoritative state-of-the-art reviews on preclinical and clinical aspects of oncology. The journal will provide up-to-date information on the latest achievements in different fields of oncology for both practising clinicians and basic researchers. Oncology Reviews aims at being international in scope and readership, as reflected also by its Editorial Board, gathering the world leading experts in both pre-clinical research and everyday clinical practice. The journal is open for publication of supplements, monothematic issues and for publishing abstracts of scientific meetings; conditions can be obtained from the Editor-in-Chief or the publisher.