Pre-diagnosis body mass index and survival after breast cancer in the After Breast Cancer Pooling Project.
Pre-diagnosis body mass index and survival after breast cancer in the After Breast Cancer Pooling Project.
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DOI：
10.1007/s10549-011-1914-3
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发表时间：
2012-04
影响因子：
3.8
通讯作者：
Caan, Bette J.
中科院分区：
文献类型：
--
作者：
Kwan, Marilyn L.;Chen, Wendy Y.;Kroenke, Candyce H.;Weltzien, Erin K.;Beasley, Jeannette M.;Nechuta, Sarah J.;Poole, Elizabeth M.;Lu, Wei;Holmes, Michelle D.;Quesenberry, Charles P., Jr.;Pierce, John P.;Shu, Xiao Ou;Caan, Bette J.
与正常体重的女性相比，肥胖和体重不足的女性患乳腺癌的存活率可能更低。然而，最佳预后的最佳体重仍在研究中。我们对14948例乳腺癌患者的诊断前体重指数（BMI）和死亡率进行了前瞻性调查。从四个前瞻性队列中抽取1990-2006年诊断为AJCC I-III期乳腺肿瘤的乳腺癌患者。使用延迟进入Cox比例风险模型估计BMI类别（世界卫生组织国际分类）与复发和死亡率之间的关联的风险比（HR）和95%置信区间（CI）。肥胖（30-<35 kg/m2）、重度肥胖（35-<40 kg/m2）和病态肥胖（≥40 kg/m2）。在平均7.8年的随访后，记录了2140例死亡和2065例复发。与正常体重（18.5-24.9 kg/m2）的女性相比，体重不足（HR=1.59; 95% CI: 1.18, 2.13）和病态肥胖女性（HR=1.81; 95% CI: 1.42, 2.32）的总死亡率风险最大。严重肥胖（HR=1.09; 95% CI: 0.88, 1.36）和肥胖（HR=1.11; 95% CI: 0.97, 1.27）与小而不显著的风险增加相关。与正常体重相比，超重（25.0-29.9 kg/m2）与任何额外风险无关。乳腺癌死亡和非乳腺癌死亡也有类似的关联，但没有复发。在乳腺癌诊断前体重过轻和病态肥胖的女性全因死亡率最高。病态肥胖的女性死于乳腺癌的风险也在增加。这些结果表明，不同程度的肥胖会导致不同的生存风险。
Obese and underweight women who develop breast cancer may have poorer survival compared to normal-weight women. However, the optimal weight for best prognosis is still under study. We conducted a prospective investigation of pre-diagnosis body mass index (BMI) and mortality among 14,948 breast cancer patients in the After Breast Cancer Pooling Project. Breast cancer patients diagnosed from 1990-2006 with AJCC Stage I-III breast tumors were drawn from four prospective cohorts. Hazard ratios (HR) and 95% confidence intervals (CI) representing the associations of BMI categories (World Health Organization international classifications) with recurrence and mortality were estimated using delayed entry Cox proportional hazards models. Obese (30-<35 kg/m2), severely obese (35-<40 kg/m2), and morbidly obese (≥40 kg/m2) were examined. After a mean follow-up of 7.8 years, 2,140 deaths and 2,065 recurrences were documented. Both underweight (HR=1.59; 95% CI: 1.18, 2.13) and morbidly obese women (HR=1.81; 95% CI: 1.42, 2.32) had the greatest risk of overall mortality compared to normal-weight (18.5-24.9 kg/m2) women. Severe obesity (HR=1.09; 95% CI: 0.88, 1.36) and obesity (HR=1.11; 95% CI: 0.97, 1.27) were related to small, non-significant increased risks. Overweight (25.0-29.9 kg/m2) was not associated with any excess risk compared to normal weight. Similar associations were found for breast cancer death and non-breast cancer death but not recurrence. Women who were underweight and morbidly obese before breast cancer diagnosis were at the greatest risk of all-cause mortality. Morbidly obese women were also at increased risk of death from breast cancer. These results suggest that degree of obesity confers differential risk on survival.
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影响因子：
158.5
作者：
Calle, EE;Thun, MJ;Heath, CW
通讯作者：
Heath, CW
影响因子：
2
作者：
DURRLEMAN, S;SIMON, R
通讯作者：
SIMON, R
影响因子：
5
作者：
CAULEY, JA;GUTAI, JP;POWELL, JG
通讯作者：
POWELL, JG
影响因子：
45.3
作者：
Goodwin, PJ;Ennis, M;Hood, N
通讯作者：
Hood, N
DOI：
10.1016/0197-2456(86)90046-2
发表时间：
1986-09-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
DERSIMONIAN, R;LAIRD, N
通讯作者：
LAIRD, N