Impact of body mass index on the short-term outcomes of resected gastrointestinal stromal tumors

Zachary E. Stiles, Tyler M. Rist, Paxton V. Dickson, Evan Glazer, Martin Fleming, David Shibata, Jeremiah Deneve

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background Potentially curative treatment for gastrointestinal stromal tumors (GIST) involves resection with selective utilization of tyrosine kinase inhibitors. A potential association between obesity and GIST has been postulated as GIST is among the most common incidental findings during gastric resection for bariatric procedures. The purpose of this study is to investigate the relationship and impact of obesity on the pathologic and short-term outcomes in patients with GIST. Methods We performed a retrospective review of patients with resected GIST. The impact of obesity, defined as body mass index (BMI) ≥30 kg/m2, on pathologic results and short-term outcomes was evaluated. Results Sixty-one patients underwent resection with a median follow-up of 26 mo (1-129 mo). Disease involved the stomach (74%), small intestine (18%), or colon/rectum (5%). Median tumor size was 6 cm, and 13 patients (21%) underwent multivisceral resection. Median BMI for the cohort was 27.2 kg/m2, and 24 patients (39%) were classified as obese based on BMI. Nonobese patients were noted to have larger primary tumors (median: 7 cm versus 5 cm, P = 0.02) and undergo multivisceral resection more frequently (32.4% versus 4.2%, P < 0.01). Short-term outcomes were similar between the groups, with a slight trend toward more postoperative complications among the obese patients. Conclusions In this study, obese patients tended to have more favorable pathologic features. GISTs may represent another example of the “obesity paradox” in which obesity seemingly provides a protective effect. Larger studies are warranted to verify the impact of obesity on outcomes and to elucidate any underlying clinicopathologic/biologic factors.

Original languageEnglish (US)
Pages (from-to)123-130
Number of pages8
JournalJournal of Surgical Research
Volume217
DOIs
StatePublished - Sep 1 2017

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Gastrointestinal Stromal Tumors
Body Mass Index
Obesity
Bariatrics
Stomach Diseases
Incidental Findings
Biological Factors
Rectum
Protein-Tyrosine Kinases
Small Intestine
Neoplasms
Stomach
Colon

All Science Journal Classification (ASJC) codes

  • Surgery

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Impact of body mass index on the short-term outcomes of resected gastrointestinal stromal tumors. / Stiles, Zachary E.; Rist, Tyler M.; Dickson, Paxton V.; Glazer, Evan; Fleming, Martin; Shibata, David; Deneve, Jeremiah.

In: Journal of Surgical Research, Vol. 217, 01.09.2017, p. 123-130.

Research output: Contribution to journalArticle

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abstract = "Background Potentially curative treatment for gastrointestinal stromal tumors (GIST) involves resection with selective utilization of tyrosine kinase inhibitors. A potential association between obesity and GIST has been postulated as GIST is among the most common incidental findings during gastric resection for bariatric procedures. The purpose of this study is to investigate the relationship and impact of obesity on the pathologic and short-term outcomes in patients with GIST. Methods We performed a retrospective review of patients with resected GIST. The impact of obesity, defined as body mass index (BMI) ≥30 kg/m2, on pathologic results and short-term outcomes was evaluated. Results Sixty-one patients underwent resection with a median follow-up of 26 mo (1-129 mo). Disease involved the stomach (74{\%}), small intestine (18{\%}), or colon/rectum (5{\%}). Median tumor size was 6 cm, and 13 patients (21{\%}) underwent multivisceral resection. Median BMI for the cohort was 27.2 kg/m2, and 24 patients (39{\%}) were classified as obese based on BMI. Nonobese patients were noted to have larger primary tumors (median: 7 cm versus 5 cm, P = 0.02) and undergo multivisceral resection more frequently (32.4{\%} versus 4.2{\%}, P < 0.01). Short-term outcomes were similar between the groups, with a slight trend toward more postoperative complications among the obese patients. Conclusions In this study, obese patients tended to have more favorable pathologic features. GISTs may represent another example of the “obesity paradox” in which obesity seemingly provides a protective effect. Larger studies are warranted to verify the impact of obesity on outcomes and to elucidate any underlying clinicopathologic/biologic factors.",
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AU - Fleming, Martin

AU - Shibata, David

AU - Deneve, Jeremiah

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N2 - Background Potentially curative treatment for gastrointestinal stromal tumors (GIST) involves resection with selective utilization of tyrosine kinase inhibitors. A potential association between obesity and GIST has been postulated as GIST is among the most common incidental findings during gastric resection for bariatric procedures. The purpose of this study is to investigate the relationship and impact of obesity on the pathologic and short-term outcomes in patients with GIST. Methods We performed a retrospective review of patients with resected GIST. The impact of obesity, defined as body mass index (BMI) ≥30 kg/m2, on pathologic results and short-term outcomes was evaluated. Results Sixty-one patients underwent resection with a median follow-up of 26 mo (1-129 mo). Disease involved the stomach (74%), small intestine (18%), or colon/rectum (5%). Median tumor size was 6 cm, and 13 patients (21%) underwent multivisceral resection. Median BMI for the cohort was 27.2 kg/m2, and 24 patients (39%) were classified as obese based on BMI. Nonobese patients were noted to have larger primary tumors (median: 7 cm versus 5 cm, P = 0.02) and undergo multivisceral resection more frequently (32.4% versus 4.2%, P < 0.01). Short-term outcomes were similar between the groups, with a slight trend toward more postoperative complications among the obese patients. Conclusions In this study, obese patients tended to have more favorable pathologic features. GISTs may represent another example of the “obesity paradox” in which obesity seemingly provides a protective effect. Larger studies are warranted to verify the impact of obesity on outcomes and to elucidate any underlying clinicopathologic/biologic factors.

AB - Background Potentially curative treatment for gastrointestinal stromal tumors (GIST) involves resection with selective utilization of tyrosine kinase inhibitors. A potential association between obesity and GIST has been postulated as GIST is among the most common incidental findings during gastric resection for bariatric procedures. The purpose of this study is to investigate the relationship and impact of obesity on the pathologic and short-term outcomes in patients with GIST. Methods We performed a retrospective review of patients with resected GIST. The impact of obesity, defined as body mass index (BMI) ≥30 kg/m2, on pathologic results and short-term outcomes was evaluated. Results Sixty-one patients underwent resection with a median follow-up of 26 mo (1-129 mo). Disease involved the stomach (74%), small intestine (18%), or colon/rectum (5%). Median tumor size was 6 cm, and 13 patients (21%) underwent multivisceral resection. Median BMI for the cohort was 27.2 kg/m2, and 24 patients (39%) were classified as obese based on BMI. Nonobese patients were noted to have larger primary tumors (median: 7 cm versus 5 cm, P = 0.02) and undergo multivisceral resection more frequently (32.4% versus 4.2%, P < 0.01). Short-term outcomes were similar between the groups, with a slight trend toward more postoperative complications among the obese patients. Conclusions In this study, obese patients tended to have more favorable pathologic features. GISTs may represent another example of the “obesity paradox” in which obesity seemingly provides a protective effect. Larger studies are warranted to verify the impact of obesity on outcomes and to elucidate any underlying clinicopathologic/biologic factors.

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