Does high body mass index influence the postoperative complications and long-term survival in patients with esophageal squamous cell carcinoma after minimally invasive esophagectomy?

Introduction: The prognostic value of high body mass index (BMI) in patients with esophageal squamous cell carcinoma (ESCC) is still controversial. Aim: To evaluate the impact of high BMI on postoperative complications and survival after minimally invasion esophagectomy (MIE) for ESCC patients. Material and methods: Three hundred and fourteen consecutive ESCC patients were used to analyze the potential association between high BMI and postoperative complications and survival. Results: Patients were divided into two groups. There was no significant difference between high and low BMI groups in terms of postoperative complications, including respiratory disease (p = 0.8362), pneumothorax (p = 0.6058), anastomotic leakage (p = 0.8678), chylothorax (p = 0.9062), cardiovascular disease (p = 0.5763), vocal cord paresis (p = 0.8349), wound infection (p = 0.5763) and perioperative death (p = 0.7179). Patients in the high BMI group had a longer operative time (p = 0.003) and more blood loss (p = 0.002) than in the low BMI group. There was no difference in number of retrieved lymph nodes between the two groups (p = 0.728). Patients could not benefit from high BMI in overall survival (OS) (p = 0.2459). High BMI was not an independent prognostic factor for survival (p = 0.1735, HR = 0.776 and 95% CI: 0.5386-1.1180). Conclusions: High BMI is associated with prolonged operative time and increased blood loss in MIE. However, high BMI is not associated with postoperative complications and not an independent prognostic factor for survival in ESCC patients who undergo MIE.