Postdiagnosis change in bodyweight and survival after breast cancer diagnosis.
Postdiagnosis change in bodyweight and survival after breast cancer diagnosis.
复制标题
DOI：
10.1097/ede.0b013e31824596a1
复制
发表时间：
2012-03
期刊：
影响因子：
--
通讯作者：
Gammon MD
中科院分区：
文献类型：
--
作者：
Bradshaw PT;Ibrahim JG;Stevens J;Cleveland R;Abrahamson PE;Satia JA;Teitelbaum SL;Neugut AI;Gammon MD
确诊后体重增加在患有乳腺癌的女性中很常见，但在少数研究其对生存影响的研究中，结果并不一致。我们调查了纽约长岛1,436名在1996-1997年间被诊断为首次乳腺癌的女性，研究了体重增加对死亡率的影响。受试者在确诊后不久接受采访，并在大约5年后再次接受采访。在成年后每十年、诊断前一年、诊断时和诊断后一年以及随访时评估体重。2005年底的死亡率是使用国家死亡指数进行评估的。在使用选择模型来解释缺失数据的同时，使用比例风险回归。与保持诊断前体重(+/−5%)的妇女相比，诊断后体重增加超过10%的妇女生存较差(危险比[HR]=2.6 7；[95%可信区间=1.3 7-5.0 5]。在确诊后的头两年，效果更为明显(5%的增长，前两年的全因死亡率，HR=5.87[0.89-47.8]，与两年后(1.49[0.85-2.57])相比；在诊断前超重的女性中(超重女性，所有原因的HR=1.91[0.91-3.88]与理想体重的女性相比，1.39[0.62-3.01]]；对于成年前增加至少3公斤的女性(>；=诊断前增加3公斤1.80[0.99-3.26]，诊断前增加3公斤1.07[0.30-3.37]。这些结果突显了乳腺癌确诊后女性保持体重的重要性。
Weight gain after diagnosis is common among women with breast cancer, yet results have been inconsistent among the few studies examining its effects on survival. We examined the effects of weight gain on mortality among a cohort of 1,436 women diagnosed with a first primary breast cancer in 1996–1997, on Long Island, NY. Subjects were interviewed soon after diagnosis and again after approximately 5 years. Weight was assessed at each decade of adult life; one year before, at and one year after diagnosis; and at the time of follow-up. Mortality through the end of 2005 was assessed using the National Death Index. Proportional hazards regression was used while employing a selection model to account for missing data. Compared with women who maintained their pre-diagnosis weight (+/− 5%), those who gained more than 10% after diagnosis had worse survival (hazard ratio [HR]= 2.67; [95% credible interval=1.37–5.05]. The effect was more pronounced during the first 2 years after diagnosis (>5% gain, all-cause mortality in the first 2 years, HR = 5.87 [0.89 – 47.8] compared with after 2 years (1.49 [0.85 – 2.57]); among women overweight before diagnosis (overweight women, all-cause HR = 1.91 [0.91 – 3.88] compared with ideal-weight women, 1.39 [0.62 – 3.01)]; and for women who had gained at least 3 kilograms over adulthood before diagnosis (>= 3 kg gain before diagnosis 1.80 [0.99 – 3.26 compared with < 3 kg gain before diagnosis 1.07 [0.30 – 3.37]. These results highlight the importance of weight maintenance for women after breast cancer diagnosis.