Kim Jae-Myung, Kim Ju-Yeon, Jung Eun Jung, Kwag Seung-Jin, Park Ji-Ho, Cho Jin-Kyu, Kim Han-Gil, Jeong Chi-Young, Ju Young-Tae, Lee Young-Joon
Department of Surgery, Gyeongsang National University Hospital, Gyeongsang National University School of Medicine, Jinju, Korea.
Department of Surgery, Gyeongsang National University Changwon Hospital, Gyeongsang National University School of Medicine, Changwon, Korea.
Korean J Clin Oncol. 2023 Dec;19(2):52-59. doi: 10.14216/kjco.23010. Epub 2023 Dec 31.
Several studies demonstrated that obesity and underweight were negatively associated with outcomes of breast cancer. However, the results are still controversial, and the impact of body mass index (BMI) on distant metastasis-free survival (MFS), which might directly affect mortality, was less well evaluated. Our study aimed to verify the prognostic effect of BMI in breast cancer.
A retrospective analysis of 504 patients with stage I-III breast cancer who underwent surgery from January 2005 to December 2013 was performed. The patients were divided into three groups according to preoperative BMI: underweight <18.5 kg/m2, normal weight 18.5-24.9 kg/m2, and overweight ≥25 kg/m2. The association between body weight status and breast cancer recurrence was analyzed. Subgroup analysis by tumor subtype according to receptor status was also performed.
The median follow-up period was 88 months. For disease recurrence, histologic grade and human epidermal growth factor receptor 2 (HER2)-positivity were independent prognostic factors in multivariate analysis. Stage, histologic grade, HER2-positivity, and BMI status were independent prognostic factors for distant metastasis. In survival analysis, overweight and underweight were significant predisposing factors for MFS, but not for disease-free survival (DFS). In the estrogen receptor (ER)-positive group, overweight and underweight patients had significantly worse DFS and MFS than normal weight patients. In the ER-negative or HER2-positive group, BMI status had no significant association with DFS and MFS.
The prognostic role of BMI on the survival outcomes of patients with breast cancer was different by tumor subtype. In ER-positive patients, overweight and underweight statuses had a negative prognostic effect on DFS and MFS, respectively.
多项研究表明，肥胖和体重过轻与乳腺癌的预后呈负相关。然而，结果仍存在争议，且体重指数（BMI）对无远处转移生存期（MFS）的影响评估较少，而MFS可能直接影响死亡率。我们的研究旨在验证BMI在乳腺癌中的预后作用。
对2005年1月至2013年12月接受手术的504例I - III期乳腺癌患者进行回顾性分析。根据术前BMI将患者分为三组：体重过轻<18.5kg/m²、正常体重18.5 - 24.9kg/m²、超重≥25kg/m²。分析体重状况与乳腺癌复发之间的关联。还根据受体状态按肿瘤亚型进行亚组分析。
中位随访期为88个月。对于疾病复发，组织学分级和人表皮生长因子受体2（HER2）阳性在多变量分析中是独立的预后因素。分期、组织学分级、HER2阳性和BMI状态是远处转移的独立预后因素。在生存分析中，超重和体重过轻是MFS的显著易感因素，但不是无病生存期（DFS）的易感因素。在雌激素受体（ER）阳性组中，超重和体重过轻患者的DFS和MFS明显比正常体重患者差。在ER阴性或HER2阳性组中，BMI状态与DFS和MFS无显著关联。
BMI对乳腺癌患者生存结局的预后作用因肿瘤亚型而异。在ER阳性患者中
