Abstract 2116P
Background
Body mass index (BMI) and waist circumference (WC) were used to evaluate nutritional status and obesity.We aimed to examine whether preoperative BMI or WC was associated with mortality after cancer surgery.
Methods
As a population-based cohort study, this study used data extracted from the National Health Insurance Service database of South Korea.We included 87,220 adult patients who underwent major cancer surgery with curative intent between January 1, 2016, and December 31, 2020.
Results
A total of 87,220 patients were included in the final analysis, and 1,374 (1.6%) died within 90 days after cancer surgery. In the multivariable logistic regression model, the BMI <18.5/kg/m2 and >35 kg/m2 groups showed 1.98-fold (odds ratio [OR]: 1.98, 95% confidence interval [CI]: 1.58, 2.49; P<0.001) and 2.62-fold (OR: 2.62, 95% CI: 1.26, 5.45; P<0.001) higher 90-day mortality after cancer surgery than did the BMI 18.5–24.9 kg/m2 group. The 25.0–29.9 kg/m2 (P=0.143) and 30.0–34.9 kg/m2 (P=0.109) BMI groups did not show significant differences compared to the BMI 18.5–24.9 kg/m2 group. Compared with the normal WC group, the high (P=0.052) and very high (P=0.236) WC groups also did not show significant differences in terms of 90-day mortality.
Table: 2116P
Subgroup analyses for 90-day mortality according to cancer surgery type
Surgery | OR (95% CI) | P-value |
Lung cancer | ||
BMI: <18.5 | 1.89 (1.08, 3.29) | 0.025 |
BMI: 25.0–29.9 | 0.82 (0.59, 1.14) | 0.235 |
BMI: 30.0–34.9 | 0.97 (0.37, 2.59) | 0.954 |
BMI: >35.0 | 5.91 (1.19, 29.312) | 0.030 |
Gastric cancer | ||
BMI: <18.5 | 2.47 (1.49, 4.10) | <0.001 |
BMI: 18.5–24.9 | 1 | |
BMI: 25.0–29.9 | 0.99 (0.70, 1.39) | 0.944 |
BMI: 30.0–34.9 | 0.32 (0.09, 1.11) | 0.072 |
BMI: >35.0 | 1.62 (0.20, 13.26) | 0.654 |
Colorectal cancer | ||
BMI: <18.5 | 2.36 (1.53, 3.65) | <0.001 |
BMI: 25.0–29.9 | 0.91 (0.68, 1.24) | 0.556 |
BMI: 30.0–34.9 | 1.01 (0.47, 2.19) | 0.979 |
BMI: >35.0 | 4.67 (1.23, 17.73) | 0.024 |
Liver cancer | ||
BMI: <18.5 | 2.22 (1.11, 4.43) | 0.024 |
BMI: 25.0–29.9 | 0.78 (0.52, 1.17) | 0.227 |
BMI: 30.0–34.9 | 0.62 (0.20, 1.94) | 0.409 |
BMI: >35.0 | 1.09 (0.12, 9.88) | 0.941 |
OR, Odds ratio; CI, confidence interval; BMI, body mass index; WC, waist circumference
Conclusions
Preoperative BMI <18.5 kg/m2 and >35 kg/m2 are associated with an elevated risk of 90-day mortality after major cancer surgery. However, preoperative WC was not significantly associated with 90-day mortality after cancer surgery.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
N/A.
Disclosure
All authors have declared no conflicts of interest.
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