PROSPERO

International prospective register of systematic reviews

The influence of body mass index on perioperative complications in esophageal cancer

patients after esophagectomy: a meta-analysis
Peiyu Wang, Yin Li, Haibo Sun, Zhengshuai Zhu, Shilei Liu

Citation
Peiyu Wang, Yin Li, Haibo Sun, Zhengshuai Zhu, Shilei Liu. The influence of body mass index on
perioperative complications in esophageal cancer patients after esophagectomy: a meta-analysis.
PROSPERO 2018 CRD42018085853 Available from:
http://www.crd.york.ac.uk/PROSPERO/display_record.php?ID=CRD42018085853

Review question
Does BMI have an effect on the incidence of individual complications for patients undergoing
esophagectomy for cancer?

Searches
PubMed, Embase and The Cochrane Library will be searched for relevant literature, from the earliest
available dates to December 31st, 2017.

Types of study to be included

Both prospective and retrospective studies from both Western and Eastern countries.

Condition or domain being studied

Body mass index has been associated with a risk of developing esophageal cancer, but the influence of BMI
on postoperative complications has been controversial.

Participants/population
Patients with esophageal cancer who have undergone esophagectomy.

Intervention(s), exposure(s)
Patient BMI, calculated and classified according to the World Health Organization criteria: underweight:
BMI<18.5 kg/m2; normal weight: BMI 18.50–24.99 kg/m2; overweight: BMI 25.00–29.99 kg/m2; obesity:
BMI?30.00 kg/m2.

Comparator(s)/control
Patients with normal weights will be the preferred comparators, although different categories of BMI will also
be compared with each other.

Primary outcome(s)
(1) Pulmonary complications or pneumonia;
(2) Cardiac complications, arrhythmia or myocardial infarction;
(3) Anastomotic leakage;
(4) Wound infection;
(5) Chylous leakage;
(6) Thromboembolic complications or pulmonary embolus.

Timing and effect measures

The main complications will be observed after esophagectomy.

Secondary outcome(s)
Perioperative mortality.

Timing and effect measures

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International prospective register of systematic reviews

Within 30 days from surgery.

Data extraction (selection and coding)

Risk of bias (quality) assessment
The risk of bias of the included studies will be assessed using approaches appropriate to the type of study
being assessed, and the funnel plot, Egger's test and Begg's test will be used to assess publication bias.

Strategy for data synthesis

A meta-analysis of the findings from the included studies will be conducted, and for each complication,
primary comparisons will be made between obese, overweight, and underweight groups and normal-weight
patients.
In addition, obese comparisons will be made with non-obese patients, and high-BMI versus low-BMI
comparisons will also be made.
If levels of heterogeneity between the included studies is found to be significant, a subgroup analysis will be
carried out, as detailed below.

Analysis of subgroups or subsets

Subgroup analyses regarding the geographical region of study will be conducted if there is found to be
significant heterogeneity.

Contact details for further information

Peiyu wang
18339979852@163.com

Organisational affiliation of the review

Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University
http://www.anti-cancer.com.cn/Html/News/Main/377.html

Review team members and their organisational affiliations

Mr Peiyu Wang. Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University
Mr Yin Li. Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University
Mr Haibo Sun. Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University
Mr Zhengshuai Zhu. Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou
University
Mr Shilei Liu. Department of Thoracic Surgery, The Affiliated Cancer Hospital of Zhengzhou University

Anticipated or actual start date

01 March 2018

Anticipated completion date

30 April 2018

Funding sources/sponsors
Mr Peiyu Wang is the sponsor and also a researcher for this meta-analysis
As the main supporter of this research, Dr Yin Li will provide assistance in the conduct of the review
Dr Haibo Sun and Dr Shilei Liu will both also act as consultants, with expertise in the field of statistics
Mr Zhengshuai Zhu will provide additional support

Conflicts of interest
None specified.

Language
English

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International prospective register of systematic reviews

Country
China

Stage of review
Review_Ongoing

Subject index terms status

Subject indexing assigned by CRD

Subject index terms

Body Mass Index; Esophageal Neoplasms; Esophagectomy; Humans; Intraoperative Complications;
Obesity; Overweight; Perioperative Care; Perioperative Period; Postoperative Complications; Risk Factors;
Treatment Outcome

Date of registration in PROSPERO

28 March 2018

Date of publication of this version

28 March 2018

Details of any existing review of the same topic by the same authors
Stage of review at time of this submission

Stage Started Completed

Preliminary searches Yes No

Piloting of the study selection process No No

Formal screening of search results against eligibility criteria No No

Data extraction No No
Risk of bias (quality) assessment No No
Data analysis No No

Versions
28 March 2018

PROSPERO
This information has been provided by the named contact for this review. CRD has accepted this information in good
faith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration
record, any associated files or external websites.

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