Schvartsman Gustavo, Gutierrez-Barrera Angelica M, Song Juhee, Ueno Naoto T, Peterson Susan K, Arun Banu
Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Cancer Med. 2017 Nov;6(11):2515-2522. doi: 10.1002/cam4.1207. Epub 2017 Oct 10.
Obese and overweight women have an increased risk of breast cancer and worse outcomes at the time of diagnosis. Women tend to gain weight after breast cancer diagnosis and during chemotherapy for early-stage disease, which may in turn increase risk for worse outcomes. We examined if weight gained during adjuvant chemotherapy was associated with worse survival outcomes. We queried our database for data on patients who received adjuvant third-generation chemotherapy for early-stage breast cancer. Univariate and multivariate analyses by Cox regression were performed for survival outcomes across three categories according to BMI variation from start to end of chemotherapy: >0.5 kg/m loss or gain and stable BMI (±0.5 kg/m ). We included 1998 patients in this study. Women over 50 years old and postmenopausal were more likely to lose weight during adjuvant chemotherapy, whereas women under 30 years old gained more weight (P < 0.001). At 1 year postchemotherapy, patients tended to return to their original weight (ρ = -0.3, P < 0.001). On multivariate analysis, BMI increase of >0.5 kg/m compared to maintaining BMI was marginally associated with increased locoregional recurrence risk (HR: 2.53; 95% CI, 1.18-5.45; P = 0.017), adjusting for grade, stage, and radiation delivery. Weight variation during adjuvant chemotherapy for early-stage breast cancer may occur as both weight gain and weight loss in a balanced manner. Furthermore, this variation seems to be transient in nature and does not appear to significantly influence recurrence rates and overall survival.
肥胖和超重女性患乳腺癌的风险增加，且在诊断时预后较差。女性在乳腺癌诊断后以及早期疾病化疗期间往往会体重增加，这反过来可能会增加预后较差的风险。我们研究了辅助化疗期间体重增加是否与较差的生存结果相关。我们在数据库中查询了接受早期乳腺癌辅助第三代化疗患者的数据。根据化疗开始到结束时BMI的变化，将患者分为三类：体重减轻或增加>0.5kg/m²以及BMI稳定（±0.5kg/m²），并通过Cox回归进行单因素和多因素分析以评估生存结果。本研究纳入了1998例患者。50岁以上的绝经后女性在辅助化疗期间更有可能体重减轻，而30岁以下的女性体重增加更多（P<0.001）。化疗后1年，患者倾向于恢复到原来的体重（ρ=-0.3，P<0.001）。多因素分析显示，与BMI保持不变相比，BMI增加>0.5kg/m²与局部区域复发风险增加有边缘相关性（HR：2.53；95%CI，1.18-5.45；P=0.017），校正了分级、分期和放疗情况。早期乳腺癌辅助化疗期间的体重变化可能以体重增加和体重减轻的平衡方式出现。此外，这种变化似乎是暂时的，并且似乎不会显著影响复发率和总生存率。
