Impact of post-diagnosis weight change on survival outcomes in Black and White breast cancer patients.
Impact of post-diagnosis weight change on survival outcomes in Black and White breast cancer patients.
复制标题
诊断后体重变化对黑白乳腺癌患者生存结果的影响。
DOI：
10.1186/s13058-021-01397-9
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发表时间：
2021-02-04
期刊：
影响因子：
--
通讯作者：
Huo D
中科院分区：
文献类型：
--
作者：
Shang L;Hattori M;Fleming G;Jaskowiak N;Hedeker D;Olopade OI;Huo D
评估乳腺癌诊断后体重随时间的变化模式，并研究黑人和白人患者诊断后体重变化与生存结果的关系。这项研究包括2000-2017年间在芝加哥被诊断为非转移性乳腺癌的2888名女性。研究人员收集了重复测量体重和身高的纵向数据，以及包括体型问题在内的问卷调查。多水平混合效应模型用于检验体重指数(BMI)的变化。采用延迟进入COX比例风险模型研究BMI斜率变化对生存结局的影响。确诊时，大多数患者超重或肥胖，黑人和白人的平均体重指数分别为27.5 kg/m2和31.5 kg/m2。值得注意的是，约45%的患者生前有恶病质，死亡前30个月左右体重开始大幅下降( )。在多变量调整分析中，与稳定体重相比，体重指数下降(>； 0.5 kg/m2/年)在总体存活率(风险比[HR] = 2.60，95%可信区间1.88-3.59)、乳腺癌特有生存率(HR = 3.05，95%可信区间1.91-4.86)和无病生存率(HR = 2.12，95%可信区间1.52-2.96)方面的风险增加2倍以上。这些关联不受种族、确诊年龄和确诊前体重的影响。体重指数增加(>； 0.5 kg/m2/年)也与较差的生存有关，但影响较小(HR = 为1.60，95%CI为1.10~2.33)。体重指数下降是乳腺癌预后恶化的有力预测因素。越来越普遍的肥胖可能掩盖了癌症恶病质的诊断，这种病可能在很大一部分乳腺癌患者死前很久就会发生。
To evaluate weight change patterns over time following the diagnosis of breast cancer and to examine the association of post-diagnosis weight change and survival outcomes in Black and White patients. The study included 2888 women diagnosed with non-metastatic breast cancer in 2000–2017 in Chicago. Longitudinal repeated measures of weight and height were collected, along with a questionnaire survey including questions on body size. Multilevel mixed-effects models were used to examine changes in body mass index (BMI). Delayed entry Cox proportional hazards models were used to investigate the impacts of changing slope of BMI on survival outcomes. At diagnosis, most patients were overweight or obese with a mean BMI of 27.5 kg/m2 and 31.5 kg/m2 for Blacks and Whites, respectively. Notably, about 45% of the patients had cachexia before death and substantial weight loss started about 30 months before death. In multivariable-adjusted analyses, compared to stable weight, BMI loss (> 0.5 kg/m2/year) showed greater than 2-fold increased risk in overall survival (hazard ratio [HR] = 2.60, 95% CI 1.88–3.59), breast cancer-specific survival (HR = 3.05, 95% CI 1.91–4.86), and disease-free survival (HR = 2.12, 95% CI 1.52–2.96). The associations were not modified by race, age at diagnosis, and pre-diagnostic weight. BMI gain (> 0.5 kg/m2/year) was also related to worse survival, but the effect was weak (HR = 1.60, 95% CI 1.10–2.33 for overall survival). BMI loss is a strong predictor of worse breast cancer outcomes. Growing prevalence of obesity may hide diagnosis of cancer cachexia, which can occur in a large proportion of breast cancer patients long before death.
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DOI：
10.1093/annonc/mdu042
发表时间：
2014-10
期刊：
Annals of oncology : official journal of the European Society for Medical Oncology
影响因子：
--
作者：
Chan DSM;Vieira AR;Aune D;Bandera EV;Greenwood DC;McTiernan A;Navarro Rosenblatt D;Thune I;Vieira R;Norat T
通讯作者：
Norat T
影响因子：
7.2
作者：
DEYO, RA;CHERKIN, DC;CIOL, MA
通讯作者：
CIOL, MA
影响因子：
45.3
作者：
Kroenke, CH;Chen, WY;Holmes, MD
通讯作者：
Holmes, MD
DOI：
10.1158/1055-9965.epi-08-1094
发表时间：
2009-05
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Nichols HB;Trentham-Dietz A;Egan KM;Titus-Ernstoff L;Holmes MD;Bersch AJ;Holick CN;Hampton JM;Stampfer MJ;Willett WC;Newcomb PA
通讯作者：
Newcomb PA
DOI：
10.1097/ede.0b013e31824596a1
发表时间：
2012-03
期刊：
Epidemiology (Cambridge, Mass.)
影响因子：
--
作者：
Bradshaw PT;Ibrahim JG;Stevens J;Cleveland R;Abrahamson PE;Satia JA;Teitelbaum SL;Neugut AI;Gammon MD
通讯作者：
Gammon MD