http://orcid.org/0000-0002-2198-8674
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Abstract
Objective: In this study, we performed a systematic review and meta-analysis to evaluate the impact of preoperative underweight status on postoperative complications and survival outcome of gastric cancer (GC) patients.
Methods: The related studies were identified by searching PubMed and Embase databases. According to the body mass index (BMI), all patients were classified into underweight group (<18.5 kg/m2) and normal weight group (≥18.5 kg/m2, <25 kg/m2). The relevant data were extracted and pooled effect size were assessed using a fixed effect model or random effect model.
Results: A total of 12 studies were included in this meta-analysis. The results indicated that underweight patients had a higher risk of postoperative complications than normal weight patients (RR: 1.28, 95% CI: 1.01–1.61, P < 0.05; I2 = 57.3%), especially for pulmonary infection (RR: 1.58, 95% CI: 1.03–2.43, P < 0.05; I2 = 47.7%). However, there was no significant difference between underweight and normal weight patients for major surgery-related complications such as anastomotic leakage, wound infection, and intra-abdominal infection. In addition, the short-term (RR: 2.12, 95% CI: 1.47–3.06, P < 0.001; I2 = 0%) and long-term survival (HR: 1.53, 95% CI: 1.14–2.07, P < 0.01; I2 = 64.0%) of underweight patients was significantly poorer than that of normal weight patients.
Conclusion: Preoperative underweight status was significantly associated with unfavorable postoperative outcome of GC patients. The status may represent excessive nutritional consumption and malnutrition resulting from aggressive tumor.
Author Contributions
Study conception and design: Bochao Zhao and Jingting Zhang; Collection and acquisition of data: Bochao Zhao, Shihui Zou and Rui Luo; Analysis and interpretation of data: Bochao Zhao, Jingting Zhang and Jiale Zhang; Drafting of manuscript: Bochao Zhao; Critical revision: Huimian Xu and Baojun Huang.