Underweight as a Risk Factor for Major Intra-abdominal Malignancy Surgeries

Area of Science:

• Oncology
• Surgical Outcomes
• Nutritional Science

Background:

• The association between body mass index (BMI) and postoperative outcomes in Asian oncology patients is debated.
• While excess adiposity is often linked to poorer cancer survival, some studies suggest overweight or obese states may improve outcomes.
• This study investigates the hypothesis that better nutrition and caloric reserves confer survival advantages in radical cancer treatment.

Purpose of the Study:

• To examine the relationship between BMI and postoperative 30-day and one-year mortality in the Asian population undergoing cancer surgery.
• To assess the impact of BMI on intensive care unit (ICU) admission rates and length of hospital stay.

Main Methods:

• A retrospective review of 646 Asian patients undergoing major abdominal cancer surgeries.
• Patients were stratified into underweight (BMI < 18.5 kg/m²), normal weight (BMI 18.5-27.5 kg/m²), and obese (BMI > 27.5 kg/m²) groups.
• Outcomes analyzed included 30-day and one-year mortality, ICU admission, and hospital length of stay.

Main Results:

• Underweight patients had 8% 30-day mortality versus 1% (normal BMI) and 3% (obese).
• One-year mortality was significantly higher in the underweight group (53%) compared to normal (14%) and obese (12%) groups (p < 0.001).
• Underweight patients showed increased ICU admissions (25% vs. 6% for normal and obese) and longer hospital stays.

Conclusions:

• Underweight status is associated with increased one-year mortality, higher ICU admission rates, and prolonged hospital stays postoperatively.
• Low BMI is identified as an independent risk factor for major radical surgeries in the Asian population.
• Findings highlight the critical role of nutritional status in surgical outcomes for cancer patients.