Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada; Department of Molecular Genetics, Faculty of Medicine, University of Toronto, Toronto, ON, Canada; Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada.
Tom Baker Cancer Centre, Alberta Health Services, Calgary, AB, Canada; Department of Oncology, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Clin Colorectal Cancer. 2020 Sep;19(3):209-218. doi: 10.1016/j.clcc.2020.02.010. Epub 2020 Feb 26.
Even though obesity is a well-established risk factor for developing colon cancer, its prognostic value is not very well understood. The present study elucidated the effect of obesity, as measured by the body mass index (BMI) and body surface area (BSA), on colon cancer outcomes.
Patients with a diagnosis of stage III colon cancer from 2011 to 2016 who had undergone adjuvant chemotherapy in Alberta, Canada were identified. The demographic variables, treatment characteristics, and survival data were collected from the electronic medical records. Obesity was defined using the BMI in accordance with the World Health Organization criteria, and BSA was categorized as ≤ 2.0 m (low) and > 2.0 m (high). The effect of BMI and BSA on 5-year cancer-specific survival (CSS) and overall survival (OS) was analyzed using univariate and multivariate analysis.
A total of 915 patients were identified with a median age of 64 years. Of these, 37% were overweight or obese, and the BSA was high in 42% of the patients. The survival outcomes for the obese and underweight patients were not significantly different from those with a normal BMI (P = .61 and P = .30 for OS and CSS, respectively). Similarly, no correlation was found between BSA and OS or CSS. Although 21% of patients experienced a > 10-week delay in receiving adjuvant chemotherapy, neither BMI nor BSA correlated significantly with chemotherapy timing (P = .45).
Our results suggest that BMI and BSA do not correlate with survival outcomes in patients with stage III colon cancer. The role of a healthy lifestyle in an improved colon cancer prognosis might not be driven by its effects on obesity.
尽管肥胖是结肠癌发病的一个公认的危险因素，但它的预后价值还不是很清楚。本研究阐明了肥胖（通过体重指数 BMI 和体表面积 BSA 来衡量）对结肠癌结局的影响。
本研究从加拿大艾伯塔省接受辅助化疗的 2011 年至 2016 年间确诊为 III 期结肠癌的患者中确定了患者。从电子病历中收集了人口统计学变量、治疗特征和生存数据。肥胖的定义是按照世界卫生组织的标准使用 BMI，BSA 分为≤2.0m（低）和>2.0m（高）。使用单变量和多变量分析来分析 BMI 和 BSA 对 5 年癌症特异性生存（CSS）和总生存（OS）的影响。
共确定了 915 例患者，中位年龄为 64 岁。其中 37%超重或肥胖，42%的患者 BSA 较高。肥胖和体重不足患者的生存结果与 BMI 正常的患者无显著差异（OS 和 CSS 的 P 值分别为 0.61 和 0.30）。同样，BSA 与 OS 或 CSS 之间也没有相关性。尽管有 21%的患者接受辅助化疗的时间延迟了>10 周，但 BMI 和 BSA 与化疗时间均无显著相关性（P 值分别为 0.45）。
我们的结果表明，BMI 和 BSA 与 III 期结肠癌患者的生存结局无关。健康的生活方式在改善结肠癌预后方面的作用可能不是通过其对肥胖的影响来驱动的。
