Impact of body mass index and weight change after treatment on cancer recurrence and survival in patients with stage III colon cancer: Findings from cancer and leukemia group B 89803
Impact of body mass index and weight change after treatment on cancer recurrence and survival in patients with stage III colon cancer: Findings from cancer and leukemia group B 89803
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DOI：
10.1200/jco.2007.15.6687
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发表时间：
2008-09-01
影响因子：
45.3
通讯作者：
Fuchs, Charles S.
中科院分区：
文献类型：
--
作者：
Meyerhardt, Jeffrey A.;Niedzwiecki, Donna;Fuchs, Charles S.
目的肥胖是结肠癌发生的危险因素之一。然而，体重指数(BMI)对已确诊结肠癌患者预后的影响仍不确定。患者和方法我们对1053名III期结肠癌患者进行了前瞻性、观察性研究，这些患者参加了一项随机的辅助化疗试验。患者报告了在辅助化疗期间和6个月后的身高和体重。结果在这组III期癌症患者中，35%的患者超重(BMI，25~29.9 kg/m(2))，34%的患者肥胖(BMI和Gt；=30 kg/m(2))。体重指数增加与结肠癌复发或死亡的风险并不显著相关(P趋势=.54)。与正常体重患者(BMI，21~24.9 kg/m(2))相比，I级肥胖者(BMI，30~34.9 kg/m(2))和II~III级肥胖者(BMI>；=35 kg/m(2)，分析后调整了肿瘤相关预后因素、体力活动、吸烟史、工作状态、年龄和性别。同样，在控制了BMI后，在辅助治疗期间至治疗结束后6个月期间的体重变化(无论是减轻还是增加)对肿瘤复发和/或死亡率没有显著影响。结论BMI和体重变化与结肠癌患者癌症复发和死亡的风险均无显著相关性。
Purpose Obesity is a risk factor for the development of colon cancer. However, the influence of body mass index (BMI) on the outcome of patients with established colon cancer remains uncertain. Moreover, the impact of change in body habitus after diagnosis has not been studied.Patients and Methods We conducted a prospective, observational study of 1,053 patients who had stage III colon cancer and who were enrolled on a randomized trial of adjuvant chemotherapy. Patients reported on height and weight during and 6 months after adjuvant chemotherapy. Patients were observed for cancer recurrence or death.Results In this cohort of patients with stage III cancer, 35% of patients were overweight (BMI, 25 to 29.9 kg/m(2)), and 34% were obese (BMI >= 30 kg/m(2)). Increased BMI was not significantly associated with a higher risk of colon cancer recurrence or death (P trend =.54). Compared with normal-weight patients (BMI, 21 to 24.9 kg/m(2)), the multivariate hazard ratio for disease-free survival was 1.00 (95% CI, 0.72 to 1.40) for patients with class I obesity (BMI, 30 to 34.9 kg/m(2)) and 1.24 (95% CI, 0.84 to 1.83) for those with class II to III obesity (BMI >= 35 kg/m(2)) after analysis was adjusted for tumor-related prognostic factors, physical activity, tobacco history, performance status, age, and sex. Similarly, after analysis was controlled for BMI, weight change (either loss or gain) during the time period between ongoing adjuvant therapy and 6 months after completion of therapy did not significantly impact on cancer recurrence and/or mortality.Conclusion Neither BMI nor weight change was significantly associated with an increased risk of cancer recurrence and death in patients with colon cancer.