Department of Cancer Medicine, Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France.
Department of Biostatistics, Institut Curie, 26 Rue D'Ulm, 75005, Paris & Saint-Cloud, France.
Breast. 2021 Feb;55:16-24. doi: 10.1016/j.breast.2020.11.014. Epub 2020 Dec 1.
High Body mass index (BMI) is a risk factor for breast cancer among postmenopausal women and an adverse prognostic factor in early-stage. Little is known about its impact on clinical outcomes in patients with metastatic breast cancer (MBC).
The National ESME-MBC observational cohort includes all consecutive patients newly diagnosed with MBC between Jan 2008 and Dec 2016 in the 18 French comprehensive cancer centers.
Of 22 463 patients in ESME-MBC, 12 999 women had BMI data available at MBC diagnosis. Median BMI was 24.9 kg/m (range 12.1-66.5); 20% of women were obese and 5% underweight. Obesity was associated with more de novo MBC, while underweight patients had more aggressive cancer features. Median overall survival (OS) of the BMI cohort was 47.4 months (95% CI [46.2-48.5]) (median follow-up: 48.6 months). Underweight was independently associated with a worse OS (median OS 33 months; HR 1.14, 95%CI, 1.02-1.27) and first line progression-free survival (HR, 1.11; 95%CI, 1.01; 1.22), while overweight or obesity had no effect.
Overweight and obesity are not associated with poorer outcomes in women with metastatic disease, while underweight appears as an independent adverse prognostic factor.
高体重指数（BMI）是绝经后妇女乳腺癌的危险因素，也是早期乳腺癌的不良预后因素。关于其对转移性乳腺癌（MBC）患者临床结局的影响知之甚少。
国家 ESME-MBC 观察性队列纳入了 2008 年 1 月至 2016 年 12 月期间在法国 18 个综合癌症中心新诊断为 MBC 的所有连续患者。
在 ESME-MBC 中，22463 名患者中，12999 名女性在 MBC 诊断时具有 BMI 数据。BMI 中位数为 24.9kg/m（范围 12.1-66.5）；20%的女性肥胖，5%的女性消瘦。肥胖与更多的新发 MBC 相关，而消瘦患者的癌症特征更为侵袭性。BMI 队列的中位总生存期（OS）为 47.4 个月（95%CI[46.2-48.5]）（中位随访：48.6 个月）。消瘦与较差的 OS（中位 OS 33 个月；HR 1.14，95%CI，1.02-1.27）和一线无进展生存期（HR，1.11；95%CI，1.01；1.22）独立相关，而超重或肥胖没有影响。
超重和肥胖与转移性疾病女性的不良结局无关，而消瘦则是独立的不良预后因素。
