Harborg Sixten, Zachariae Robert, Olsen Julia, Johannsen Maja, Cronin-Fenton Deirdre, Bøggild Henrik, Borgquist Signe
Department of Oncology, Aarhus University Hospital/Aarhus University, Aarhus, Denmark.
Department of Clinical Epidemiology, Aarhus University, Aarhus, Denmark.
NPJ Breast Cancer. 2021 Sep 10;7(1):119. doi: 10.1038/s41523-021-00325-6.
We conducted a systematic review and meta-analysis investigating the association between overweight and outcome in triple-negative breast cancer (TNBC) patients. We searched PubMed and Embase using variations of the search terms triple-negative breast cancer (population), overweight and/or obesity (exposure), and prognosis (outcome). Based on the World Health Organization guidelines for defining overweight, we included longitudinal observational studies, which utilized survival statistics with hazard ratios (HRs) in our analysis. The included studies measured body mass index at the time of diagnosis of TNBC and reported disease-free survival and/or overall survival. Study quality was assessed with the Newcastle-Ottawa Scale and study data were extracted using the Meta-analysis of Observational Studies in Epidemiology (MOOSE) checklist, independently by two authors. Random-effects models were used to combine the effect sizes (HRs), and the results were evaluated and adjusted for possible publication bias. Thirteen studies of 8,944 TNBC patients were included. The meta-analysis showed that overweight was associated with both shorter disease-free survival (HR = 1.26; 95%CI: 1.09-1.46) and shorter overall survival (HR = 1.29; 95%CI: 1.11c1.51) compared to normal-weight. Additionally, our Bayesian meta-analyses suggest that overweight individuals are 7.4 and 9.9 times more likely to have shorter disease-free survival and overall survival, respectively. In conclusion, the available data suggest that overweight is associated with shorter disease-free and overall survival among TNBC patients. The results should be interpreted with caution due to possible publication bias.
我们进行了一项系统评价和荟萃分析，以研究超重与三阴性乳腺癌（TNBC）患者预后之间的关联。我们在PubMed和Embase数据库中进行检索，使用了搜索词“三阴性乳腺癌（人群）”“超重和/或肥胖（暴露因素）”以及“预后（结局）”的不同变体。根据世界卫生组织超重定义指南，我们纳入了纵向观察性研究，并在分析中使用了带有风险比（HRs）的生存统计数据。纳入的研究在TNBC诊断时测量了体重指数，并报告了无病生存期和/或总生存期。使用纽卡斯尔-渥太华量表评估研究质量，并由两位作者独立使用流行病学观察性研究荟萃分析（MOOSE）清单提取研究数据。采用随机效应模型合并效应量（HRs），并对结果进行评估和调整以校正可能存在的发表偏倚。纳入了13项涉及8944例TNBC患者的研究。荟萃分析表明，与体重正常者相比，超重与较短的无病生存期（HR = 1.26；95%CI：1.09 - 1.46）和较短的总生存期（HR = 1.29；95%CI：1.11 - 1.51）相关。此外，我们的贝叶斯荟萃分析表明，超重个体的无病生存期和总生存期较短的可能性分别高出7.4倍和9.9倍。总之，现有数据表明超重与TNBC患者较短的无病生存期和总生存期相关。由于可能存在发表偏倚，对结果的解释应谨慎。
