Breast cancer outcomes in a population with high prevalence of obesity
Breast cancer outcomes in a population with high prevalence of obesity
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DOI：
10.1016/j.jss.2015.03.088
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发表时间：
2015-10-01
影响因子：
2.2
通讯作者：
Kim, Roger H.
中科院分区：
文献类型：
--
作者：
Herlevic, Vincent C.;Mowad, Ronald;Kim, Roger H.
背景：肥胖与乳腺癌预后不良有关。然而，以前的大多数研究都是研究肥胖患者比例相对较低的人群。鉴于预测到2030年肥胖率将超过50%，检查肥胖率较高人群中乳腺癌的结果是很重要的。我们假设，在肥胖率较高的人群中，以体重指数(BMI)衡量的肥胖与浸润性乳腺癌患者总体生存率和无病生存率的下降有关。方法：对1997年至2013年间在某学术医学中心接受浸润性乳腺癌治疗的前瞻性数据库进行了回顾。BMI是根据每个患者确诊时的身高和体重计算出来的。根据世界卫生组织建立的定义，患者被归类为正常(BMI 30 kg/m(2))。结果：共有523例浸润性乳腺癌患者进入分析。根据BMI，87人(16%)被归类为正常，150人(29%)超重，286人(55%)肥胖。中位随访期为49个月。正常组死亡16例(18.4%)，超重组死亡25例(16.7%)，肥胖组死亡45例(15.7%)(P=0.84)。经Kaplan-Meier生存分析，三组患者的总生存期(P=0.49)和无病生存期(P=0.33)差异均无统计学意义。结论：在肥胖率较高的患者群体中，肥胖与总生存期或无病生存期的下降无关。这些发现表明，在肥胖率较低的人群中观察到的肥胖乳腺癌患者预后不良的原因可能还有其他因素。(C)2015 Elsevier Inc.保留所有权利。
Background: Obesity has been associated with poor prognosis in breast cancer. However, most previous studies examined populations with relatively low proportions of obese patients. Given that forecasts predict obesity rates to exceed 50% by 2030, it is important to examine breast cancer outcomes in populations with higher rates of obesity. We hypothesized that obesity, as measured by body mass index (BMI), is associated with decreased overall survival and disease-free survival in patients with invasive breast cancer in a population with a high prevalence of obesity.Methods: A retrospective review of a prospectively maintained database was conducted on patients treated for invasive breast cancer at an academic medical center between 1997 and 2013. BMI was calculated from each patient's height and weight at the time of diagnosis. Patients were categorized as normal (BMI 30 kg/m(2)), as per the definitions established by the World Health Organization. The end points of overall survival and disease-free survival were analyzed.Results: A total of 523 patients with invasive breast cancer were included for analysis. Based on BMI, 87 (16%) were categorized as normal, 150 (29%) were overweight, and 286 (55%) were obese. The median follow-up was 49 mo. There were 16 deaths (18.4%) in normal patients, 25 (16.7 %) in overweight patients, and 45 (15.7%) in obese patients (P = 0.84). By Kaplan-Meier survival analysis, there were no differences in overall survival (P = 0.49) or in disease-free survival (P = 0.33) among the three groups.Conclusions: Obesity is not associated with decreased overall or disease-free survival in a patient population with a high prevalence of obesity. These findings suggest that there may be other factors that contribute to the poor prognosis of obese breast cancer patients observed in populations with lower rates of obesity. (C) 2015 Elsevier Inc. All rights reserved.