This article is more than 5 years old. Information may no longer be current.
Chemoradiotherapy complications lower among obese patients with esophageal carcinoma
Click Here to Manage Email Alerts
Obese patients with esophageal cancer who underwent chemoradiotherapy did not experience worse disease outcomes and had reduced risk for high-grade esophagitis, hematologic toxicity and esophageal stricture compared with patients with lower BMI in a recent study.
Researchers at the University of Texas MD Anderson Cancer Center retrospectively identified 405 patients with nonmetastatic esophageal cancer between March 2002 and April 2010. All had received chemotherapy and radiotherapy with or without surgery, and were categorized as either obese (n=290; BMI≥25 kg/m2) or nonobese (n=115; BMI<25 kg/m2). Progression-free survival (PFS), overall survival (OS) and pathologic complete response (pCR) were determined using Cox proportional hazards regression and Kaplan-Meier analyses.
Among patients (obese, n=162; nonobese, n=44) who underwent surgery after receiving neoadjuvant therapy, postoperative complications were similar between groups. Obese patients, however, had significantly fewer gastrointestinal complications (23.1% compared with 42.9%; P=.011) than nonobese patients, including anastomotic leaks and ileus.
When researchers reviewed treatment-related toxicities after chemoradiotherapy, they found that obese patients (n=290) were less likely to have grade 2 or greater esophagitis (59% vs. 71.3%; P=.021), grade 1 or greater esophageal stricture toxicity (9% vs. 27.8%; P<.001) and high-grade hematologic toxicity (28.6% vs. 47%; P<.001) than nonobese patients (n=115).
On multivariate analysis obese patients were not associated with worse pCR (OR=0.994; 95% CI, 0.454-2.175) or OS (OR=1.032; 95% CI, 0.73-1.459) than nonobese patients. Five-year OS rates were 40.5% for obese patients compared with 41.9% for nonobese patients. Obesity also was not associated with worse positron emission tomography tumor response (P=.46) nor operative morbidity/mortality (P>.05) under univariate analysis.
“Obesity was not predictive for poorer disease outcomes, such as pCR, OS, or PFS,” the researchers concluded. “Despite more comorbidities, higher BMI patients were not found to experience increased risk of surgical complications. Furthermore, obesity was associated with reduced risk of several radiation-/chemotherapy-related treatment toxicities.”
Click Here to Manage Email Alerts