Body Mass Index and Weight Loss in Metastatic Colorectal Cancer in CALGB (Alliance)/SWOG 80405.
Body Mass Index and Weight Loss in Metastatic Colorectal Cancer in CALGB (Alliance)/SWOG 80405.
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CALGB转移性结直肠癌的体重指数和体重减轻（联盟）/SWOG 80405。
DOI：
10.1093/jncics/pkaa024
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发表时间：
2020-06
影响因子：
4.4
通讯作者：
Meyerhardt JA
中科院分区：
文献类型：
--
作者：
Guercio BJ;Zhang S;Venook AP;Ou FS;Niedzwiecki D;Lenz HJ;Innocenti F;Mullen BC;O'Neil BH;Shaw JE;Polite BN;Hochster HS;Atkins JN;Goldberg RM;Brown JC;O'Reilly EM;Mayer RJ;Blanke CD;Fuchs CS;Meyerhardt JA
在非转移性结直肠癌中，与其他患者相比，超重和轻度至中度肥胖患者的结局有所改善。肥胖对晚期或转移性结直肠癌（mCRC）的影响相对未被探索。我们在癌症和白血病组B（现为Alliance）/SWOG 80405中进行了一项前瞻性体重指数（BMI）伴随研究，这是一项III期转移性结直肠癌（mCRC）治疗试验。在试验登记时测量BMI。主要和次要终点分别为总生存期和无进展生存期。为了最大限度地减少健康状况不佳和快速下降的混杂因素，我们使用考克斯比例风险回归来调整已知的预后因素、合并症、体力活动和进入研究前6个月的体重减轻。我们还检查了入组前体重减轻作为患者结局的独立预测因素。所有统计学检验均为双侧检验。在2323例mCRC患者中，BMI与总生存期或无进展生存期之间无统计学显著相关性（调整后的P趋势分别为0.12和0.40）。研究入组前6个月内的体重减轻与较短的总体和无进展生存期相关;与体重稳定± 4.9%的个体相比，体重减轻超过15%的个体的全因死亡率校正风险比为1.52（95%置信区间[CI] = 1.26至1.84; Ptrend < .001）和疾病进展或死亡的1.23（95% CI = 1.02至1.47; Ptrend = .006）。在这项针对mCRC患者的前瞻性研究中，一线化疗开始时的BMI与患者结局无关。研究入组前体重减轻与患者死亡和疾病进展风险增加相关。
In nonmetastatic colorectal cancer, overweight and mild-to-moderately obese patients experience improved outcomes compared with other patients. Obesity’s influence on advanced or metastatic colorectal cancer (mCRC) is relatively unexplored. We conducted a prospective body mass index (BMI) companion study in Cancer and Leukemia Group B (now Alliance)/SWOG 80405, a phase III metastatic colorectal cancer (mCRC) treatment trial. BMI was measured at trial registration. Primary and secondary endpoints were overall and progression-free survival, respectively. To minimize confounding by poor and rapidly declining health, we used Cox proportional hazards regression to adjust for known prognostic factors, comorbidities, physical activity, and weight loss during the 6 months prior to study entry. We also examined weight loss prior to enrollment as an independent predictor of patient outcome. All statistical tests were two-sided. Among 2323 patients with mCRC, there were no statistically significant associations between BMI and overall or progression-free survival (adjusted Ptrend = .12 and .40, respectively). Weight loss during the 6 months prior to study entry was associated with shorter overall and progression-free survival; compared with individuals with stable weight ±4.9%, individuals with weight loss greater than 15% experienced an adjusted hazard ratio of 1.52 for all-cause mortality (95% confidence interval [CI] = 1.26 to 1.84; Ptrend < .001) and of 1.23 for disease progression or death (95% CI = 1.02 to 1.47; Ptrend = .006). In this prospective study of patients with mCRC, BMI at time of first-line chemotherapy initiation was not associated with patient outcome. Weight loss prior to study entry was associated with increased risk of patient mortality and disease progression.
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影响因子：
7.1
作者：
Larsson, Susanna C.;Wolk, Alicja
通讯作者：
Wolk, Alicja
影响因子：
45.3
作者：
Campbell, Peter T.;Newton, Christina C.;Gapstur, Susan M.
通讯作者：
Gapstur, Susan M.
影响因子：
4.4
作者：
Brown, Justin C.;Zhang, Sui;Meyerhardt, Jeffrey A.
通讯作者：
Meyerhardt, Jeffrey A.
影响因子：
28.4
作者：
Kroenke, Candyce H.;Neugebauer, Romain;Caan, Bette J.
通讯作者：
Caan, Bette J.
影响因子：
5.4
作者：
ChasanTaber, S;Rimm, EB;Willett, WC
通讯作者：
Willett, WC