Kawai Hideki, Saito Yoshitaro, Suzuki Yohei
Department of Thoracic Surgery, Akita Red Cross Hospital, Kamikitate, Akita, Japan.
Interact Cardiovasc Thorac Surg. 2017 Aug 1;25(2):272-277. doi: 10.1093/icvts/ivx092.
The aim of this study was to investigate gender differences in the relationship between preoperative body mass index (BMI), postoperative body weight change and prognosis in patients with non-small cell lung cancer (NSCLC).
Two hundred and sixty-three patients with NSCLC were enrolled in this study. Preoperative BMI was categorized based on WHO definition as follows: underweight (BMI <18.5): 21 patients (8.0%), normal (18.5 ≦ BMI <25): 179 patients (68%), overweight and obese (BMI ≧25): 63 patients (24%). Several factors such as age, sex, cancer stage, body weight change and BMI were recorded and correlated to the postoperative overall survival (OS).
For male patients, those in the low-BMI group had the worst prognosis (P < 0.05) whereas female patients with low BMI did not. Male patients with low BMI had statistically significant poorer prognosis compared to corresponding female patients (P < 0.05). Male patients with more than 5% body weight loss within 1 year after operation when compared to preoperative body weight had poorer prognosis than those with less than 5% body weight loss (P < 0.001). Furthermore, these male patients had statistically significant worse prognosis than the corresponding female patients (P < 0.05). In multivariable analysis, gender, more than 5% of body weight loss compared to preoperative body weight, and pathological stage were independent prognostic factors in NSCLC.
This study illustrates significant gender differences in the relationship between prognosis and BMI or body weight change in patients with postoperative NSCLC.
本研究旨在调查非小细胞肺癌(NSCLC)患者术前体重指数(BMI)、术后体重变化与预后之间关系的性别差异。
本研究纳入了263例NSCLC患者。根据世界卫生组织的定义,术前BMI分类如下:体重过轻(BMI<18.5):21例患者(8.0%);正常(18.5≤BMI<25):179例患者(68%);超重和肥胖(BMI≥25):63例患者(24%)。记录了年龄、性别、癌症分期、体重变化和BMI等几个因素,并将其与术后总生存期(OS)相关联。
对于男性患者,低BMI组的预后最差(P<0.05),而低BMI的女性患者则不然。低BMI的男性患者与相应的女性患者相比,预后在统计学上显著更差(P<0.05)。术后1年内体重较术前下降超过5%的男性患者比体重下降少于5%的患者预后更差(P<0.001)。此外,这些男性患者的预后在统计学上比相应的女性患者更差(P<0.05)。在多变量分析中,性别、术后体重较术前下降超过5%以及病理分期是NSCLC的独立预后因素。
本研究表明,NSCLC患者术后预后与BMI或体重变化之间的关系存在显著的性别差异。