Cortesi Laura, Sebastiani Federica, Iannone Anna, Marcheselli Luigi, Venturelli Marta, Piombino Claudia, Toss Angela, Federico Massimo
Department of Oncology and Hematology, Azienda Ospedaliero-Universitaria di Modena, 41124 Modena, Italy.
Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, 41124 Modena, Italy.
Cancers (Basel). 2020 Jun 27;12(7):1709. doi: 10.3390/cancers12071709.
Background obesity and sedentary lifestyle have been shown to negatively affect survival in breast cancer (BC). The purpose of this study was to test the efficacy of a lifestyle intervention on body mass index (BMI) and physical activity (PA) levels among BC survivors in Modena, Italy, in order to show an outcome improvement in obese and overweight patients.
This study is a single-arm experimental design, conducted between November 2009 and May 2016 on 430 women affected by BC. Weight, BMI, and PA were assessed at baseline, at 12 months, and at the end of the study. Survival curves were estimated among normal, overweight, and obese patients.
Mean BMI decreased from baseline to the end of the study was equal to 2.9% ( = 0.065) in overweight patients and 3.3% in obese patients ( = 0.048). Mean PA increase from baseline to the end of the study was equal to 125% ( < 0.001) in normal patients, 200% ( < 0.001) in overweight patients and 100% ( < 0.001) in obese patients. After 70 months of follow-up, the 5-year overall survival (OS) rate was 96%, 96%, and 93%, respectively in normal, obese, and overweight patients. Overweight patients had significantly worse OS than normal ones (HR = 3.69, 95%CI = 1.82-4.53 = 0.027) whereas no statistically significant differences were seen between obese and normal patients (HR 2.45, 95%CI = 0.68-8.78, = 0.169).
A lifestyle intervention can lead to clinically meaningful weight loss and increase PA in patients with BC. These results could contribute to improving the OS in obese patients compared to overweight ones.
背景 肥胖和久坐不动的生活方式已被证明会对乳腺癌(BC)患者的生存产生负面影响。本研究的目的是测试生活方式干预对意大利摩德纳BC幸存者体重指数(BMI)和身体活动(PA)水平的效果,以显示肥胖和超重患者的预后改善情况。
本研究采用单臂实验设计,于2009年11月至2016年5月对430例BC女性患者进行。在基线、12个月时以及研究结束时评估体重、BMI和PA。估计正常、超重和肥胖患者的生存曲线。
从基线到研究结束,超重患者的平均BMI下降了2.9%(P = 0.065),肥胖患者下降了3.3%(P = 0.048)。从基线到研究结束,正常患者的平均PA增加了125%(P < 0.001),超重患者增加了200%(P < 0.001),肥胖患者增加了100%(P < 0.001)。随访70个月后,正常、肥胖和超重患者的5年总生存率(OS)分别为96%、96%和93%。超重患者的OS明显比正常患者差(HR = 3.69,95%CI = 1.82 - 4.53,P = 0.027),而肥胖患者和正常患者之间未观察到统计学上的显著差异(HR 2.45,9%CI = 0.68 - 8.78,P = 0.169)。
生活方式干预可使BC患者实现具有临床意义的体重减轻并增加PA。与超重患者相比,这些结果可能有助于改善肥胖患者的OS。