Influence of body mass index on postoperative complications and survival in esopha-geal squamous cell carcinoma patients based on propensity score matching method
10.3969/j.issn.1000-8179.2018.11.301
- VernacularTitle:应用倾向值匹配法评价体质指数对食管鳞癌患者术后并发症及生存率的影响
- Author:
Guo MIN
1
;
Cui WANG
;
Nan ZHANG
;
Xiumin YIN
;
Liting NIE
;
Gongchao WANG
Author Information
1. 山东大学护理学院
- Keywords:
squamous cell carcinoma (ESCC);
body mass index;
propensity score matched;
complications;
survival
- From:
Chinese Journal of Clinical Oncology
2018;45(11):589-594
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To explore the influence of body mass index (BMI) on postoperative complications and survival in patients with esophageal squamous cell carcinoma (ESCC) using propensity score matched (PSM) methods. Methods: We retrospectively analyzed clinical data of 533 patients with ESCC who were admitted for thoracic surgery in Shandong Provincial Hospital, between January 2011 and December 2012. After conducting PSM methods to balance the covariates, the incidence of postoperative complications and sur-vival rate were compared between the two groups. The effects of BMI on postoperative complications and survival were analyzed with multivariate Logistic regression and Cox proportional hazard analyses, respectively. Survival analysis was performed using Kaplan-Mei-er curves and Log-rank test. Results: After adjusting the PSM and confounding variables, the two groups were well matched (146 pa-tients each) without significant differences in baseline characteristics. The incidence of wound infection and respiratory system compli-cations in the H-BMI group (BMI≥25 kg/m2) were significantly higher than those in the N-BMI group (18.5-25 kg/m2) (P<0.05). H-BMI was an independent risk factor for wound infection and respiratory system complications. In the present study, no significant differ-ence was observed in the 3-year overall survival between H-BMI and N-BMI patients (54.1% vs. 47.8%, P=0.212). Patients with H-BMI had significantly better 5-year overall survival than those with N-BMI (39% vs. 25%, P=0.016). The subgroup analysis showed that pa-tients with H-BMI had a better overall survival than those with N-BMI in stages Ⅰ-Ⅱ (47.3% vs. 29.0%, P=0.032). However, this difference was not significant when patients were stratified into stages Ⅲ and Ⅳ (24.5% vs. 16.7%, P=0.393). Conclusions: H-BMI appears not to decrease the overall survival of patients with ESCC. Therefore, ESCC in patients with H-BMI can receive surgical treatment safely, but proper intraoperative management and close postoperative monitoring should be performed.
