Obesity Is an Independent Prognostic Variable in Colon Cancer Survivors
Obesity Is an Independent Prognostic Variable in Colon Cancer Survivors
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DOI：
10.1158/1078-0432.ccr-09-2636
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发表时间：
2010-03-15
影响因子：
11.5
通讯作者：
Rankin, Cathryn
中科院分区：
文献类型：
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作者：
Sinicrope, Frank A.;Foster, Nathan R.;Rankin, Cathryn
目的：肥胖与结肠癌风险增加有关。然而，体重指数（BMI）对结肠癌幸存者预后的影响及其与性别的关系仍不清楚。 实验设计：BMI（kg/m（2））对II期和III期结肠癌肿瘤淋巴结转移患者（n = 4,381）进行分类，纳入七项基于5-氟尿嘧啶的辅助化疗随机试验。使用Cox比例风险模型来确定BMI与无病生存（DFS）和总生存（OS）的关联。结果：在结肠癌患者中，868名（20％）肥胖（BMI，=>=0kg/m（2）），其中606名为1级（BMI，30-34kg/m（2）），262名为2,3级（BMI，>=35）千克/米(2))。与正常体重的患者相比，肥胖患者更可能更年轻、患有远端肿瘤、表现出完整的 DNA 错配修复以及更多的淋巴结转移 (P < 0.017)。在多变量分析中，BMI 与 DFS (P = 0.030) 和 OS (P = 0.0017) 显着相关。与正常体重男性相比，2,3 级肥胖男性的 OS 降低[风险比，1.35； 95%置信区间，1.02-1.79； P = 0.039]。 I 级肥胖女性的 OS 降低[风险比，1.24； 95%置信区间，1.01-1.53； P = 0.045]与正常体重女性相比。超重状态与男性 OS 改善相关 (P = 0.006)，体重过轻的女性 OS 明显较差 (P = 0.019)。 BMI 不能预测治疗效果。结论：肥胖是结肠癌幸存者的一个独立预后变量，并显示出性别相关的差异。这些数据表明，肥胖相关的生物因素可以影响临床结果。临床癌症研究； 16(6)； 1884-93。 (C) 2010 AACR。
Purpose: Obesity is associated with an increased risk of colon cancer. However, the influence of body mass index (BMI) on the prognosis of colon cancer survivors and its relationship to gender remains unknown.Experimental Design: BMI (kg/m(2)) was categorized in patients with tumor-node-metastasis stage II and III colon carcinomas (n = 4,381) enrolled in seven randomized trials of 5-fluorouracil-based adjuvant chemotherapy. Cox proportional hazards models were used to determine the association of BMI with disease-free survival (DFS) and overall survival (OS).Results: Among colon cancer patients, 868 (20%) were obese (BMI, = >= 0 kg/m(2)), of which 606 were class 1 (BMI, 30-34 kg/m(2)) and 262 were class 2,3 (BMI, >= 35 kg/m(2)). Obese versus normal-weight patients were more likely to be younger, have distal tumors, show intact DNA mismatch repair, and have more lymph node metastases (P < 0.017). In a multivariate analysis, BMI was significantly associated with both DFS (P = 0.030) and OS (P = 0.0017). Men with class 2,3 obesity showed reduced OS compared with normal-weight men [hazard ratio, 1.35; 95% confidence interval, 1.02-1.79; P = 0.039]. Women with class I obesity had reduced OS [hazard ratio, 1.24; 95% confidence interval, 1.01-1.53; P = 0.045] compared with normal-weight women. Overweight status was associated with improved OS in men (P = 0.006), and underweight women had significantly worse OS (P = 0.019). BMI was not predictive of therapeutic benefit.Conclusions: Obesity is an independent prognostic variable in colon cancer survivors and shows gender-related differences. These data suggest that obesity-related biological factors can influence clinical outcome. Clin Cancer Res; 16(6); 1884-93. (C) 2010 AACR.