Authors' Affiliations: Divisions of Medical Oncology and Internal Medicine; Office of the Scientific Director, Galliera Hospital; IRCCS San Martino-IST, Genoa; IRCCS-IRST, Romagna Cancer Institute, Meldola (FC); and University of Padova, Padova, Italy.
Cancer Epidemiol Biomarkers Prev. 2013 Oct;22(10):1862-7. doi: 10.1158/1055-9965.EPI-13-0595. Epub 2013 Aug 14.
The effect of body mass index (BMI) on the prognosis of metastatic breast cancer (MBC) has not been explored so far.
The relationship between BMI (kg/m(2)) and progression-free survival (PFS) or overall survival (OS) was assessed in 489 patients with MBC enrolled in three clinical trials of first-line chemotherapy. World Health Organization BMI categories were used: normal, 18.5-24.9 kg/m(2); overweight, 25-29.9 kg/m(2); and obese, 30+ kg/m(2). Univariate PFS and OS curves were estimated; multivariate Cox analysis was conducted adjusting for age, menopausal status, performance status (PS), hormonal status and site, and number of metastases.
Overall, 39.9% of the patients were normal or underweight, 37.8% were overweight, and 22.3% were obese. Median age was 57 years (range 25-73); median PS was 0. Median PFS was 10.9 months [interquartile range (IQR) 5.5 to 19.9] in normal weight women, 13.0 months (IQR 7.8 to 23.7) in overweight, and 12.2 (IQR 7.1 to 23.0) in obese women, P = 0.17. Median OS was 32.0 months [95% confidence interval (CI), 14.5-88.3] versus 33.2 months (95% CI, 19.4-81.1) and 30.7 (95% CI, 17.6-50.8), respectively. In multivariate analyses, no statistically significant association between BMI category and PFS or OS was observed.
In this study, BMI was not associated with the outcome of patients with MBC treated with first-line chemotherapy.
In the absence of any evidence in support of a prognostic role of obesity in patients with MBC treated with chemotherapy, dietary restrictions, medical interventions aimed at reducing BMI/insulin resistance, or specific anticancer treatment strategies do not seem to be appropriate.
目前尚未研究体重指数（BMI）对转移性乳腺癌（MBC）预后的影响。
对 3 项一线化疗临床试验中 489 例 MBC 患者的 BMI（kg/m2）与无进展生存（PFS）或总生存（OS）之间的关系进行评估。采用世界卫生组织 BMI 类别：正常体重 18.5-24.9kg/m2；超重 25-29.9kg/m2；肥胖 30kg/m2 以上。估计单变量 PFS 和 OS 曲线；对年龄、绝经状态、表现状态（PS）、激素状态和部位、转移部位数量进行调整，进行多变量 Cox 分析。
患者中，39.9%为正常体重或体重不足，37.8%为超重，22.3%为肥胖。中位年龄为 57 岁（25-73 岁）；中位 PS 为 0。正常体重妇女的中位 PFS 为 10.9 个月（四分位距 5.5-19.9），超重妇女为 13.0 个月（7.8-23.7），肥胖妇女为 12.2 个月（7.1-23.0），P=0.17。中位 OS 为 32.0 个月（95%CI 14.5-88.3）、33.2 个月（95%CI 19.4-81.1）和 30.7 个月（95%CI 17.6-50.8）。多变量分析中，BMI 类别与 PFS 或 OS 之间无统计学显著关联。
在这项研究中，BMI 与接受一线化疗的 MBC 患者的预后无关。
在没有任何证据支持肥胖对接受化疗的 MBC 患者具有预后作用的情况下，限制饮食、旨在降低 BMI/胰岛素抵抗的医疗干预措施，或特定的抗癌治疗策略似乎并不合适。
