Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies.
Body mass index and survival in women with breast cancer-systematic literature review and meta-analysis of 82 follow-up studies.
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DOI：
10.1093/annonc/mdu042
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发表时间：
2014-10
期刊：
影响因子：
--
通讯作者：
Norat T
中科院分区：
文献类型：
--
作者：
Chan DSM;Vieira AR;Aune D;Bandera EV;Greenwood DC;McTiernan A;Navarro Rosenblatt D;Thune I;Vieira R;Norat T
目前的系统性文献综述和荟萃分析扩展并证实了肥胖与绝经前和绝经后乳腺癌的总体生存率和乳腺癌生存率不利的相关性，无论何时确定BMI。体重不足和超重妇女的死亡风险增加，以及与总死亡率的J形关联也被观察到。由于肥胖是一种流行性健康问题，因此终生保持健康体重的建议非常重要。肥胖与乳腺癌后生存率之间的正相关性在先前发表数据的荟萃分析中得到证实，但仅总结了肥胖与非肥胖的比较结果。我们在MEDLINE和EMBASE中系统性检索了乳腺癌幸存者诊断前后的体重指数（BMI），以及截至2013年6月的总死亡率和死因特异性死亡率的随访研究，作为世界癌症研究基金会持续更新项目的一部分。随机效应荟萃分析进行了探索的幅度和形状的协会。确定了82项研究，包括213 075例乳腺癌幸存者，41 477例死亡（23 182例死于乳腺癌）。对于确诊前的BMI，与正常体重女性相比，肥胖女性总死亡率的汇总相对危险度（RR）为1.41 [95%置信区间（CI）1.29-1.53（BMI >30.0），1.07（95%CI 1.02-1.12）为超重（BMI 25.0-<30.0）和1.10（95%CI 0.92-1.31）为体重不足（BMI <18.5）的妇女。对于肥胖女性，绝经前和绝经后乳腺癌的汇总RR分别为1.75（95% CI 1.26-2.41）和1.34（95% CI 1.18-1.53）。在诊断前、诊断后<12个月和诊断后≥ 12个月，BMI每增加5 kg/m2，总死亡率的风险分别增加17%、11%和8%，乳腺癌死亡率的风险分别增加18%、14%和29%。肥胖与绝经前和绝经后乳腺癌的总体生存率和乳腺癌生存率较差相关，无论何时确定BMI。超重也与较高的死亡风险有关。需要随机临床试验来测试乳腺癌妇女减肥和维持生存的干预措施。
The current systematic literature review and meta-analysis extends and confirms the associations of obesity with an unfavourable overall and breast cancer survival in pre and postmenopausal breast cancer, regardless of when BMI is ascertained. Increased risks of mortality in underweight and overweight women and J-shape associations with total mortality were also observed. The recommendation of maintaining a healthy body weight throughout life is important as obesity is a pandemic health concern. Positive association between obesity and survival after breast cancer was demonstrated in previous meta-analyses of published data, but only the results for the comparison of obese versus non-obese was summarised. We systematically searched in MEDLINE and EMBASE for follow-up studies of breast cancer survivors with body mass index (BMI) before and after diagnosis, and total and cause-specific mortality until June 2013, as part of the World Cancer Research Fund Continuous Update Project. Random-effects meta-analyses were conducted to explore the magnitude and the shape of the associations. Eighty-two studies, including 213 075 breast cancer survivors with 41 477 deaths (23 182 from breast cancer) were identified. For BMI before diagnosis, compared with normal weight women, the summary relative risks (RRs) of total mortality were 1.41 [95% confidence interval (CI) 1.29–1.53] for obese (BMI >30.0), 1.07 (95 CI 1.02–1.12) for overweight (BMI 25.0–<30.0) and 1.10 (95% CI 0.92–1.31) for underweight (BMI <18.5) women. For obese women, the summary RRs were 1.75 (95% CI 1.26–2.41) for pre-menopausal and 1.34 (95% CI 1.18–1.53) for post-menopausal breast cancer. For each 5 kg/m2 increment of BMI before, <12 months after, and ≥12 months after diagnosis, increased risks of 17%, 11%, and 8% for total mortality, and 18%, 14%, and 29% for breast cancer mortality were observed, respectively. Obesity is associated with poorer overall and breast cancer survival in pre- and post-menopausal breast cancer, regardless of when BMI is ascertained. Being overweight is also related to a higher risk of mortality. Randomised clinical trials are needed to test interventions for weight loss and maintenance on survival in women with breast cancer.
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影响因子：
5
作者：
Bekkering, Geertruida E.;Harris, Ross J.;Sterne, Jonathan A. C.
通讯作者：
Sterne, Jonathan A. C.
影响因子：
5.4
作者：
Crujeiras, A. B.;Cueva, J.;Casanueva, F. F.
通讯作者：
Casanueva, F. F.
影响因子：
50.5
作者：
Berclaz, G;Li, S;International Breast Cancer Study Grp
通讯作者：
International Breast Cancer Study Grp
影响因子：
2.2
作者：
ABE, R;KUMAGAI, N;NAKAMURA, T
通讯作者：
NAKAMURA, T
DOI：
10.1186/bcr2891
发表时间：
2011-06-03
期刊：
Breast cancer research : BCR
影响因子：
--
作者：
Allin KH;Nordestgaard BG;Flyger H;Bojesen SE
通讯作者：
Bojesen SE