Body Mass Index, Chemotherapy-Related Weight Changes, and Disease-Free Survival in Haitian Women With Nonmetastatic Breast Cancer.
Body Mass Index, Chemotherapy-Related Weight Changes, and Disease-Free Survival in Haitian Women With Nonmetastatic Breast Cancer.
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DOI：
10.1200/go.20.00307
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发表时间：
2020-10
影响因子：
4.5
通讯作者：
Rebbeck TR
中科院分区：
文献类型：
--
作者：
Fadelu T;Damuse R;Lormil J;Pecan E;Greenberg L;Dubuisson C;Pierre V;Triedman SA;Shulman LN;Rebbeck TR
很少有研究探讨非洲血统的加勒比妇女的体型和乳腺癌结果之间的关系。本研究评估了224例海地女性非转移性乳腺癌患者的回顾性队列中体重指数（BMI）与无病生存期（DFS）之间的关系。从病历中获得BMI，并将其分类为正常体重（<25 kg/m2）、超重（25 - 29.9 kg/m2）和肥胖（≥ 30 kg/m2）。DFS定义为从手术切除到疾病复发、死亡或删失的时间。生成Kaplan-Meier生存曲线，并使用考克斯比例风险模型评估BMI和DFS之间的关联，以控制多种混杂因素。对辅助化疗期间的体重变化进行了探索性分析。83例（37.1%）体重正常，66例（29.5%）超重，75例（33.5%）肥胖。BMI组的基线特征或接受的治疗无统计学差异。26名患者死亡，73名患者复发。中位DFS为41.1个月。Kaplan-Meier估计值显示BMI类别之间无显著DFS差异。在控制混杂因素后，正常体重患者与超重和肥胖患者相比，校正后的风险比分别为0.85（95%CI，0.49至1.49）和0.90（95%CI，0.52至1.55）。总体而言，在辅助化疗过程中观察到平均体重减轻2%。绝经后（P = 0.007）和肥胖（P = 0.05）的患者比其他组体重减轻更多。然而，化疗相关的体重变化对DFS没有影响。在该队列中，基线BMI和辅助化疗期间的体重变化对DFS没有影响。未来需要在类似的加勒比乳腺癌队列中进行前瞻性研究，以验证研究结果。
Few studies have explored the relationship between body habitus and breast cancer outcomes in Caribbean women of African ancestry. This study evaluates the association between body mass index (BMI) and disease-free survival (DFS) in a retrospective cohort of 224 female Haitian patients with nonmetastatic breast cancer. BMI was obtained from the medical records and categorized as normal weight (< 25 kg/m2), overweight (25-29.9 kg/m2), and obese (≥ 30 kg/m2). DFS was defined as time from surgical resection to disease recurrence, death, or censoring. Kaplan-Meier survival curves were generated, and the association between BMI and DFS was evaluated using Cox proportional hazard models to control for multiple confounders. Exploratory analyses were conducted on weight changes during adjuvant chemotherapy. Eighty-three patients (37.1%) were normal weight, 66 (29.5%) were overweight, and 75 (33.5%) were obese. There were no statistical differences in baseline characteristics or treatments received by BMI group. Twenty-six patients died and 73 had disease recurrence. Median DFS was 41.1 months. Kaplan-Meier estimates showed no significant DFS differences by BMI categories. After controlling for confounders, normal weight patients, when compared with overweight and obese patients, had adjusted hazard ratios of 0.85 (95% CI, 0.49 to 1.49) and 0.90 (95% CI, 0.52 to 1.55), respectively. Overall, mean weight loss of 2% of body weight was noted over the course of adjuvant chemotherapy. Patients who were postmenopausal (P = .007) and obese (P = .05) lost more weight than other groups. However, chemotherapy-related weight changes did not have an impact on DFS. Baseline BMI and weight changes during adjuvant chemotherapy did not have an impact on DFS in this cohort. Future prospective studies in similar Caribbean breast cancer cohorts are needed to verify study findings.