Gut Liver.  2023 Mar;17(2):243-258. 10.5009/gnl220104.

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

• Jo HH
• Kim N
• Jang J
• Choi Y
• Park J
• Park YM
• Ahn S
• Yoon H
• Shin CM
• Park YS
• Lee DH
• Oh HJ
• Lee HS
• Park YS
• Ahn SH
• Suh YS
• Park DJ
• Kim HH
• Kim JW
• Kim JW
• Lee KW
• Chang W
• Park JH
• Lee YJ
• Lee KH
• Kim YH

• KMID: 2540413
• DOI: http://doi.org/10.5009/gnl220104

Abstract

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).

Keyword

Stomach neoplasms; Body mass index; Sex; Aging; Survival