Relationship between obesity and pathologic response to neoadjuvant chemotherapy among women with operable breast cancer
Relationship between obesity and pathologic response to neoadjuvant chemotherapy among women with operable breast cancer
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DOI：
10.1200/jco.2007.14.4527
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发表时间：
2008-09-01
影响因子：
45.3
通讯作者：
Brewster, Abenaa M.
中科院分区：
文献类型：
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作者：
Litton, Jennifer K.;Gonzalez-Angulo, Ana M.;Brewster, Abenaa M.
为了解乳腺癌患者肥胖与不良预后的关系，我们评估了可手术乳腺癌患者的体重指数(BMI)和对新辅助化疗(NC)的反应。患者被分类为肥胖(BMI=30 kg/m(2))、超重(BMI为25~30 kg/m(2))或正常/体重不足(BMI<；25 kg/m(2))。采用Logistic回归分析BMI与病理完全应答(PCR)之间的关系。使用Kaplan-Meier方法和Cox比例风险回归分析来检验乳腺癌的特异性、无进展和总体生存时间。结果中位年龄为50岁，30%的患者肥胖，32%的患者超重，38%的患者体重正常或偏低。在多因素分析中，肥胖组与正常体重组比较差异无统计学意义(优势比[OR]=0.78；95%CI，0.49~1.26)。超重和超重与肥胖合并的患者发生聚合酶链式反应的可能性显著降低(OR=0.59；95%CI，0.37~0.95；OR=0.67；95%CI，0.45~0.99)。肥胖患者患激素阴性肿瘤的可能性更大(P
Purpose To understand the mechanism through which obesity in breast cancer patients is associated with poorer outcome, we evaluated body mass index (BMI) and response to neoadjuvant chemotherapy (NC) in women with operable breast cancer.Patients and Methods From May 1990 to July 2004, 1,169 patients were diagnosed with invasive breast cancer at M. D. Anderson Cancer Center and received NC before surgery. Patients were categorized as obese (BMI >= 30 kg/m(2)), overweight (BMI of 25 to < 30 kg/m(2)), or normal/underweight (BMI < 25 kg/m(2)). Logistic regression was used to examine associations between BMI and pathologic complete response (pCR). Breast cancer -specific, progression-free, and overall survival times were examined using the Kaplan-Meier method and Cox proportional hazards regression analysis. All statistical tests were two-sided.Results Median age was 50 years; 30% of patients were obese, 32% were overweight, and 38% were normal or underweight. In multivariate analysis, there was no significant difference in pCR for obese compared with normal weight patients (odds ratio [OR] = 0.78; 95% Cl, 0.49 to 1.26). Overweight and the combination of overweight and obese patients were significantly less likely to have a pCR (OR = 0.59; 95% Cl, 0.37 to 0.95; and OR = 0.67; 95% Cl, 0.45 to 0.99, respectively). Obese patients were more likely to have hormone-negative tumors (P