Prognostic value of preoperative weight loss-adjusted body mass index on survival after esophagectomy for esophageal squamous cell carcinoma

BACKGROUND The impact of body mass index(BMI)on survival in patients with esophageal squamous cell carcinoma(ESCC)undergoing surgery remains unclear.Therefore,a definition of clinically significant BMI in patients with ESCC is needed.AIM To explore the impact of preoperative weight loss(PWL)-adjusted BMI on overall survival(OS)in patients undergoing surgery for ESCC.METHODS This retrospective study consisted of 1545 patients who underwent curative resection for ESCC at West China Hospital of Sichuan University between August 2005 and December 2011.The relationship between PWL-adjusted BMI and OS was examined,and a multivariate analysis was performed and adjusted for age,sex,TNM stage and adjuvant therapy.RESULTS Trends of poor survival were observed for patients with increasing PWL and decreasing BMI.Patients with BMI≥20.0 kg/m2 and PWL<8.8%were classified into Group 1 with the longest median OS(45.3 mo).Patients with BMI<20.0 kg/m2 and PWL<8.8%were classified into Group 2 with a median OS of 29.5 mo.Patients with BMI≥20.0 kg/m2 and PWL≥8.8%(HR=1.9,95%CI:1.5-2.5),were combined into Group 3 with a median OS of 20.1 mo.Patients in the three groups were associated with significantly different OS(P<0.05).In multivariate analysis,PWL-adjusted BMI,TNM stage and adjuvant therapy were identified as independent prognostic factors.CONCLUSION PWL-adjusted BMI has an independent prognostic impact on OS in patients with ESCC undergoing surgery.BMI might be an indicator for patients with PWL<8.8%rather than≥8.8%.

A remote,fully oriented personalized program of physical exercise for women in follow-up after breast cancer treatment improves body composition and physical fitness

This study aimed to evaluate the efficacy of an individualized remote exercise program on the improvement of body composition and physical fitness of a heterogeneous group of patients who completed breast cancer treatment.This prospective study included 107 women aged 18 to 60,shortly after curative treatment for localized breast cancer,at the Erasto Gaertner Cancer Hospital(HEG)in Curitiba,PR,Brazil.Body composition,maximal oxygen consumption,and muscle resistance were evaluated after nine months of intervention while considering adherence to the program,level of physical activity,presence of binge eating disorder,tumor classification,and treatment type.Seventy-eight women(72.8%)adhered to the training program.Adherent participants showed significant changes in body mass([-4.3±3.6]kg;p<0.0001),body mass index([-1.6±1.5]kg·m^(−2);p<0.0001),body fat(−3.4%±3.1%;p<0.0001),maximal oxygen consumption([7.5±2.0]ml·kg^(−1)·min^(−1));p<0.0001),and abdominal resistance([11.2±2.8]reps;p<0.0001).In contrast,these variables did not change significantly in the non-adherent group.Among the adherent participants,those subclassified in the severe binge group showed a more noticeable reduction in body mass,body mass index,and body fat(p<0.05)than those in the non-binge group.Individualized remotely-guided physical exercise programs can improve the body composition and physical fitness of women undergoing post-breast cancer surveillance,regardless of pathological history or treatment.