Does the “obesity paradox” really exist in lung cancer surgery? —maybe we should recognize what is the “obesity” first

Although there are many other measures for subject body composition, the body mass index (BMI), calculated by the total weight divided by the square of height, has been widely accepted as a universal tool for the patient health risk assessment. A dramatic increase in baseline BMI has been reported to show a definitive correlation to a range of metabolic, cardiovascular, and malignant diseases (1,2). Current evidence demonstrates that the patients with BMI ≥30 kg/m², who are generally considered as the ‘obese’ patients in routine clinical practice, may have both significantly higher morbidity and mortality rates after elective surgery, especially after cardiac operations (3,4). However, it seems that such “obese” patients may have a lower mortality rate after lung cancer surgery (3).