231. A NOMOGRAM BASED ON BODY MASS INDEX CHANGES TO PREDICT PROGNOSIS AFTER CURATIVE RESECTION OF ESOPHAGEAL SQUAMOUS CELL CARCINOMA

Abstract

Abstract This study aims to investigate the relationship between preoperative body mass index changes (∆BMI) and prognosis in patients with esophageal squamous cell carcinoma who underwent esophagectomy. We identified 1883 patients with esophageal squamous cell carcinoma who underwent R0 resection in our department between January 2005 and December 2013. Patients were grouped into no decrease (∆BMI = 0) group and any decrease (∆BMI > 0) group. The impact of ∆BMI on survival was investigated by using Kaplan–Meier curve and Cox regression modelling. A nomogram was constructed, and model performance was examined. The ∆BMI > 0 patients had worse 5-year overall survival rate than ∆BMI = 0 patients (26.8% vs 44.7% respectively, P < 0.001). Preoperative ∆BMI was an independent prognostic factor in patients with esophageal squamous cell carcinoma (HR: 1.174, 95%CI: 1.014–1.358, P = 0.032). In subgroup analysis, major ∆BMI was associated with increased risk of poor prognosis when compared with minor ∆BMI (HR: 1.184, 95%CI: 1.031–1.359, P = 0.017). The prognostic nomogram presented good predictive ability with a C-index of 0.705 (Figure). This study demonstrates that decreased body mass index had adverse impact on long-term survival in patients with esophageal squamous cell carcinoma who underwent curative esophagectomy. These results support application of nutrition support for the major ∆BMI group.