Influence of Body Mass Index on Long-Term Outcome in Patients with Rectal Cancer—A Single Centre Experience

• Main Authors: Maximilian Kalb, Melanie C. Langheinrich, Susanne Merkel, Christian Krautz, Maximilian Brunner, Alan Bénard, Klaus Weber, Christian Pilarsky, Robert Grützmann, Georg F. Weber
• Format: Article
• Language: English
• Published: MDPI AG 2019-04-01
• Series: Cancers
• Subjects: body mass index; rectal cancer; overall survival; distant metastasis
• Online Access: https://www.mdpi.com/2072-6694/11/5/609

Background: Excess bodyweight is known to influence the risk of colorectal cancer; however, little evidence exists for the influence of the body mass index (BMI) on the long-term outcome of patients with rectal cancer. Methods: We assessed the impact of the BMI on the risk of local recurrence, distant metastasis and overall&#8212;survival in 612 patients between 2003 and 2010 after rectal cancer diagnosis and treatment at the University Hospital Erlangen. A Cox-regression model was used to estimate the hazard ratio and multivariate risk of mortality and distant-metastasis. Median follow up-time was 58 months. Results: Patients with obesity class II or higher (BMI &#8805; 35 kg/m², <i>n</i> = 25) and patients with underweight (BMI &lt; 18.5 kg/m², <i>n</i> = 5) had reduced overall survival (hazard ratio (HR) = 1.6; 95% confidence interval (CI) 0.9&#8722;2.7) as well as higher rates of distant metastases (hazard ratio HR = 1.7; 95% CI 0.9&#8722;3.3) as compared to patients with normal bodyweight (18.5 &#8804; BMI &lt; 25 kg/m², <i>n</i> = 209), overweight (25 &#8804; BMI &lt;30 kg/m², <i>n</i> = 257) or obesity class I (30 &#8804; BMI &lt;35 kg/m², <i>n</i> = 102). There were no significant differences for local recurrence. Conclusions: Underweight and excess bodyweight are associated with lower overall survival and higher rates of distant metastasis in patients with rectal cancer.