Positive Effect of Higher Adult Body Mass Index on Overall Survival of Digestive System Cancers Except Pancreatic Cancer: A Systematic Review and Meta-Analysis.

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diabetes mellitus 1 endocrinologydiseases
obesity 22 endocrinologydiseases

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diabetes mellitus 24401 anastomosis, and cardiovascular diseases [[6], [11], [12], [23], [47]]. Obese cases had higher rate of diabetes mellitus , which may influence the healing of DSC patients after treatment [[12]]. The mechanisms behind the observation
obesity 1409 overweight cases was 0.76 (95% CI = 0.67–0.85). DSC individuals except pancreatic cancer with adult obesity were at decreased risk for OS (HR = 0.85, 95% CI = 0.72–0.98). Among DSC patients except pancreatic
obesity 1887 increased OS among adult overweight and obese DSC survivors except pancreatic cancer. Overweight and obesity in adulthood may be important prognostic factors that indicate an increased survival from DSC patients
obesity 3437 meta-analysis of the association between BMI and OS of pancreatic cancer. Their analysis showed that obesity in adulthood shortened OS of pancreatic cancer patients (HR = 1.29, 95% CI = 1.17–1.41) [[14]]. This
obesity 11537 CancerNine studies (eight prospective and one retrospective study) were included in the analysis of obesity and survival of DSC patients except pancreatic cancer (Figure 3). Pooled HR of five studies for obesity
obesity 11641 obesity and survival of DSC patients except pancreatic cancer (Figure 3). Pooled HR of five studies for obesity at diagnosis time was 0.89 (95% CI = 0.69–1.09). No significant heterogeneity was found (I2 = 40.2%,
obesity 11847 40.2%, Pheterogeneity = 0.153). Meta-analysis of four prospective studies on the association of adult obesity and OS of DSC participants revealed that pooled HR was 0.85 (95% CI = 0.72–0.98), without obvious
obesity 14888 funnel plot for OS of DSC patients except pancreatic cancer and overweight (Begg test P = 0.467) or obesity (Begg test P = 0.329) showed no asymmetry (Figure 10). Begg test for highest versus lowest BMI category
obesity 15257 regression test for all groups also suggested no obvious publication bias.4. DiscussionOverweight and obesity account for approximately 20% of all cancer patients, including esophageal adenocarcinoma, colorectal
obesity 15477 and pancreatic cancer (RR range from 1.07 to 1.52, for male cases) [[44]–[46]]. Apart from cancers, obesity was observed to be related to cardiovascular disease, chronic kidney disease, sleeping disorder, and
obesity 17127 latest meta-analysis of BMI and OS of pancreatic cancer in April of 2016. Results suggested that adult obesity of pancreatic cancer cases may shorten OS (HR = 1.29, 95% CI = 1.17–1.41), while obesity at diagnosis
obesity 17218 that adult obesity of pancreatic cancer cases may shorten OS (HR = 1.29, 95% CI = 1.17–1.41), while obesity at diagnosis was not associated with the mortality (HR = 1.10, 95% CI = 0.78–1.42) [[14]].The mechanism
obesity 17362 the mortality (HR = 1.10, 95% CI = 0.78–1.42) [[14]].The mechanism behind the results that adult obesity enhanced the OS of pancreatic cancer had not been revealed thoroughly. Increased insulin resistance,
obesity 17830 characteristic of pancreatic cancer may result in the difference.Prognostic effect of overweight and obesity on DSCs has been searched. However, the role of BMI at diagnosis and in adulthood on the mortality of
obesity 18912 adjusting, especially for weight loss and tumor grade, were performed as a supplement. Overweight and obesity in adulthood significantly enhanced the OS of DSC patients except pancreatic cancer. But we failed to
obesity 19073 patients except pancreatic cancer. But we failed to find significant association between overweight or obesity at diagnosis and OS of DSCs except pancreatic cancer. Pooled analysis of both overweight and obesity
obesity 19174 obesity at diagnosis and OS of DSCs except pancreatic cancer. Pooled analysis of both overweight and obesity revealed positive effect on survival of DSC patients except pancreatic cancer: HR = 0.78 (95% CI = 0.69–0.87)
obesity 23235 all-cause mortality risk among overweight colorectal cancer patients; HRs (95% CI) for overweight and obesity were 0.79 (0.71–0.88) and 0.88 (0.77–1.00), respectively [[48]]. Additionally, the relationship
obesity 24134 effect. However, higher BMI also had a higher incidence of complication after treatment. Overweight and obesity in esophageal survivors may induce anastomotic leakage (RR = 1.04, 95% CI = 1.02–1.06), wound infection
obesity 25630 BMI of patients; the data may be inaccurate due to rapid weight change around operation. Abdominal obesity may increase the mortality of general population and influence the OS of DSC patients, but we have no
obesity 26386 were less than actual proportion in DSC patients.5. ConclusionThis study revealed that overweight and obesity in adulthood increased the OS of DSC patients except pancreatic cancer. However, higher BMI at diagnosis
obesity 27520 ((1) at diagnosis, (2) in adulthood).Figure 3Forest plot showed hazard ratios (HRs) and 95% CIs for obesity and overall survival of DSC except pancreatic cancer. HRs are for BMI at diagnosis and in adulthood.
obesity 28662 plot test for higher BMI and overall survival of DSC except pancreatic cancer. ((a) overweight, (b) obesity ).Figure 11Begg funnel plot test for the highest versus lowest BMI and overall survival of DSC. ((a)

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