Body mass index at diagnosis and survival among colon cancer patients enrolled in clinical trials of adjuvant chemotherapy.
Body mass index at diagnosis and survival among colon cancer patients enrolled in clinical trials of adjuvant chemotherapy.
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DOI：
10.1002/cncr.27938
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发表时间：
2013-04-15
期刊：
影响因子：
6.2
通讯作者：
Sargent, Daniel J.
中科院分区：
文献类型：
--
作者：
Sinicrope, Frank A.;Foster, Nathan R.;Yothers, Greg;Benson, Al;Seitz, Jean Francois;Labianca, Roberto;Goldberg, Richard M.;DeGramont, Aimery;O'Connell, Michael J.;Sargent, Daniel J.
尽管肥胖是罹患结肠癌的既定危险因素，但其对结肠癌幸存者的预后影响以及与患者性别的关系仍不清楚。我们在辅助结肠癌终点 (ACCENT) 数据库中检查了体重指数 (BMI) 对 II 期和 III 期结肠癌患者 (N=25,291) 的预后和预测影响。 BMI 在 5-氟尿嘧啶辅助化疗随机试验入组时进行测量。使用 Cox 回归模型确定 BMI 与复发时间 (TTR)、无病生存 (DFS) 和总生存 (OS) 的关联。统计检验是双面的。在中位随访 7.8 年期间，与超重或正常体重患者相比，肥胖和体重不足患者的生存率明显较差。在多变量分析中，BMI 的不良预后影响见于男性，但未见于女性 (Pinteraction=.0129)。与正常体重患者相比，2/3 级肥胖男性 (BMI ≥ 35.0 kg/m2) 的 DFS 显着降低 [HR= 1.16 (1.01, 1.33), p=.0297] 体重不足的患者 TTR 显着缩短，DFS 降低 [HR=1.18 (1.09, 1.28), p<.0001]，男性的 DFS 降低更为显着 [HR= 1.31] (1.15, 1.50), p<.0001] 高于女性 [1.11 (1.01, 1.23), .0362； Pinteraction=.0340）。 BMI 不能预测辅助治疗的益处。肥胖和体重不足状态与接受辅助化疗试验的结肠癌患者的不良结局独立相关。
Although obesity is an established risk factor for developing colon cancer, its prognostic impact and relationship to patient sex in colon cancer survivors remains unclear. We examined the prognostic and predictive impact of the body mass index (BMI) in stage II and III colon carcinoma patients (N=25,291) within the Adjuvant Colon Cancer Endpoints (ACCENT) database. BMI was measured at enrollment in randomized trials of 5-fluorouracil-based adjuvant chemotherapy. Association of BMI with time-to-recurrence (TTR), disease-free (DFS), and overall survival (OS) was determined using Cox regression models. Statistical tests were two-sided. During a median follow-up of 7.8 years, obese and underweight patients had significantly poorer survival compared to overweight or normal-weight patients. In a multivariable analysis, the adverse prognostic impact of BMI was seen in men but not in women (Pinteraction=.0129). Men with class 2/3 obesity (BMI ≥35.0 kg/m2) had a statistically significant reduction in DFS [HR= 1.16 (1.01, 1.33), p=.0297] vs normal weight patients Underweight patients had a significantly shorter TTR and reduced DFS [HR=1.18 (1.09, 1.28), p<.0001] that was stronger among men [HR= 1.31 (1.15, 1.50), p<.0001] than women [1.11 (1.01, 1.23), .0362; Pinteraction=.0340). BMI was not predictive of adjuvant treatment benefit. Obesity and underweight status were independently associated with inferior outcomes in colon cancer patients treated in adjuvant chemotherapy trials.
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影响因子：
120.7
作者：
Flegal, KM;Carroll, MD;Johnson, CL
通讯作者：
Johnson, CL
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120.7
作者：
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作者：
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