Prediagnostic adult body mass index change and esophageal adenocarcinoma survival.

BACKGROUND: We examined whether body mass index (BMI) changes in adulthood, prior to disease onset, are associated with overall survival among esophageal adenocarcinoma patients. METHODS: We included 285 histologically confirmed patients with a complete baseline BMI questionnaire. Using extended Cox regression models, we obtained adjusted hazard ratios (HRs) for the associations between overall survival and BMI at diagnosis, BMI 6 months before diagnosis, self-reported average adult BMI, and DeltaBMI (BMI 6 months before diagnosis minus average adult BMI), categorized into tertiles /=0 and /=1.25 kg/m(2) (BMI gain). We also assessed interaction between DeltaBMI and average adult BMI (>/= kg/m(2) versus 25 and /= 27.5 kg/m(2) who gained BMI had the worst survival (HR = 3.05; 95% CI 1.62-5.72; P < .01). CONCLUSION: Body mass index gain in adulthood is associated with poor overall survival, and maintaining a normal body weight throughout adulthood is associated with the best overall survival among esophageal adenocarcinoma patients, independent of BMI at diagnosis.