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Obesity Ups Esophageal Cancer Mortality in Never Smokers

Obesity tied to disease-specific, disease-free, overall survival in never, but not ever, smokers

THURSDAY, Oct. 13 (HealthDay News) -- For never smokers with esophageal adenocarcinoma (EAC), obesity is independently associated with deterioration of disease-specific survival (DSS), disease-free survival (DFS), and overall survival (OS) after esophagectomy, according to a study published online Oct. 11 in the Journal of Clinical Oncology.

Harry H. Yoon, M.D., from the Mayo Clinic in Rochester, Minn., and colleagues investigated the prognostic impact of obesity on EAC, and the potential modification by smoking status. A total of 778 patients with EAC who underwent potentially curative esophagectomy were analyzed. Participants were divided into obese (≥30 kg/m²), overweight (25 to 29.9 kg/m²), and normal weight (18.5 to 24.9 kg/m²) based on their body mass index (BMI) at the time of surgery. The correlation of BMI with DSS, DFS, and OS was assessed in never or ever cigarette smokers.

The investigators found that there was a significant correlation between BMI and DSS which differed considerably with smoking status. After adjusting for covariates, in never smokers, obesity significantly correlated with adverse DSS, DFS, and OS compared to normal-weight patients (hazard ratio, 2.11, 2.03, and 1.97, respectively). However, obesity was not prognostic in ever smokers, and overweight status significantly correlated with favorable survival in univariate, but not multivariate analysis.

"Obesity is independently associated with increased mortality among never, but not ever, smokers," the authors write.

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