Al Jarroudi Ouissam, Abda Naima, Seddik Youssef, Brahmi Sami Aziz, Afqir Said
Service of Medical Oncology, University Hospital Mohammed VI-Oujda, Morocco. Email:
Asian Pac J Cancer Prev. 2017 Jun 25;18(6):1519-1523. doi: 10.22034/APJCP.2017.18.6.1519.
Background: Obesity is associated with poor outcomes in patients with breast cancer expressing hormone receptors, but this association is not well established for triple-negative breast cancer. In this study, we investigated the influence of body mass index (BMI) in triple-negative breast cancer outcomes. Methods: This is a descriptive and analytical retrospective cohort study at the Regional Oncology Center Hassan II-Oujda. We identified 115 patients with triple-negative breast cancer, met the criteria for inclusion, treated between January 2009 and December 2011. The clinicopathological characteristics were collected to assess the association between BMI and overall survival and disease-free survival at 5 years, using the Kaplan-Meier and Cox model. Results: Data analysis focused on 115 patients, 34 patients (28.7%) were normal weight (BMI < 25) and 82 patients (71.3%) were overweight (BMI ≥ 25). The rates of overall mortality and progression at 5 years were 37.4% and 69.6% respectively. After adjusting for clinicopathological variables and menopausal status, overweight was associated with OS (HR: 2.903, 95% CI: 1.551- 5.432, p = 0.001) and DFS (HR:1.899, 95% IC: 1.05 – 3.433, p=0.034) in all patients with triple-negative breast cancer. When stratified by menopausal status, overweight was associated with DFS and OS (HR : 3.242, 95% CI: 1.249 to 8.412, p = 0.016) and (HR : 2.752, 95% CI: 1.267 to 5.978, p = 0.011) respectively in pre-menopausal women. By cons, BMI was not associated with DFS or OS in postmenopausal women. Conclusions: Overweight is an independent prognostic factor for OS and DFS at 5 years in all patients with triple-negative breast cancer, and menopausal status may be a mitigating factor. Premenopausal women with overweight are at greater risk of death and progression than women with normal weight. Once validated, these results should be considered in the development of prevention programs.
肥胖与激素受体阳性乳腺癌患者的不良预后相关，但这种关联在三阴性乳腺癌中尚未得到充分证实。在本研究中，我们调查了体重指数（BMI）对三阴性乳腺癌预后的影响。方法：这是一项在哈桑二世 - 乌季达地区肿瘤中心进行的描述性和分析性回顾性队列研究。我们确定了115例符合纳入标准的三阴性乳腺癌患者，这些患者于2009年1月至2011年12月期间接受治疗。收集临床病理特征，使用Kaplan - Meier法和Cox模型评估BMI与5年总生存率和无病生存率之间的关联。结果：数据分析集中在115例患者，34例患者（28.7%）体重正常（BMI < 25），82例患者（71.3%）超重（BMI≥25）。5年时的总死亡率和疾病进展率分别为37.4%和69.6%。在调整临床病理变量和绝经状态后，超重与所有三阴性乳腺癌患者的总生存期（HR：2.903，95% CI：1.551 - 5.432，p = 0.001）和无病生存期（HR：1.899，95% IC：1.05 - 3.433，p = 0.034）相关。按绝经状态分层时，超重分别与绝经前女性的无病生存期和总生存期相关（HR：3.242，95% CI：1.249至8.412，p = 0.016）和（HR：2.752，95% CI：1.267至5.978，p = 0.011）。相比之下，BMI与绝经后女性的无病生存期或总生存期无关。结论：超重是所有三阴性乳腺癌患者5年总生存期和无病生存期的独立预后因素，绝经状态可能是一个缓解因素。超重的绝经前女性比体重正常的女性有更高的死亡和进展风险。一旦得到验证，这些结果在预防方案的制定中应予以考虑。
