Kong Yu-Huan, Huang Jing-Yi, Ding Ye, Chen Shu-Hua, Li Qiu-Shuang, Xiong Yang
School of Pharmaceutical Sciences, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.
Academy of Chinese Medical Science, Zhejiang Chinese Medical University, Hangzhou, 310053, Zhejiang, China.
Clin Transl Oncol. 2025 Feb;27(2):403-416. doi: 10.1007/s12094-024-03563-9. Epub 2024 Jul 16.
The main goal of the present research is to explore the potential link of body mass index (BMI) with different survival metrics in breast cancer patients. Our aim is to offer the latest and most thorough meta-analysis, assessing the strength and reliability of the connection that BMI has with prognostic indicators in this disease.
As of January 2024, we conducted a systematic literature search across PubMed, Embase, Web of Science, and the Cochrane Library databases. Our search aimed to identify studies examining BMI as an exposure factor, with breast cancer patients constituting the study population, and utilizing adjusted hazard ratio (HR) as the data type of interest.
The evidence synthesis incorporated a total of 61 eligible articles involving 201,006 patients. Being underweight posed a risk factor for overall survival (OS) in breast cancer patients compared to normal weight (HR 1.15, 95% CI 0.98-1.35; P = 0.08). Overweight or obesity, in comparison to normal weight, was a risk factor for OS (HR 1.18, 95% CI 1.14-1.23; P < 0.00001), disease-free survival (DFS) (HR 1.11, 95% CI 1.08-1.13; P < 0.00001), relapse-free survival (RFS) (HR 1.14, 95% CI 1.06-1.22; P = 0.03), and breast cancer-specific survival (BCSS) (HR 1.18, 95% CI 1.11-1.26; P < 0.00001), but not for progression-free survival (PFS) (HR 0.91, 95% CI 0.76-1.10; P = 0.33). Notably, in subgroup analyses, overweight patients achieved prolonged PFS (HR 0.80, 95% CI 0.64-0.99; P = 0.04), and compared to the obese population, the overweight cohort exhibited a significant difference in OS (HR 1.11, 95% CI 1.05-1.16; P < 0.00001) and DFS (HR 1.06, 95% CI 1.03-1.10; P = 0.0004), with a considerably stronger association. Furthermore, compared to HER- patients, HER + patients exhibited a greater predictive value for OS (HR 1.23, 95% CI 1.10-1.37; P = 0.0004), RFS (HR 1.30, 95% CI 1.03-1.64; P < 0.00001), and DFS (HR 1.10, 95% CI 1.03-1.17; P = 0.003).
The results of our meta-analysis reveal a notable association between BMI and various survival measures in breast cancer prognosis. These findings provide a solid basis for predicting breast cancer outcomes and implementing more effective therapeutic approaches.
本研究的主要目标是探讨体重指数（BMI）与乳腺癌患者不同生存指标之间的潜在联系。我们的目的是提供最新、最全面的荟萃分析，评估BMI与该疾病预后指标之间联系的强度和可靠性。
截至2024年1月，我们在PubMed、Embase、科学网和考克兰图书馆数据库中进行了系统的文献检索。我们的检索旨在识别将BMI作为暴露因素进行研究的文献，研究人群为乳腺癌患者，并将调整后的风险比（HR）作为感兴趣的数据类型。
证据综合纳入了总共61篇符合条件的文章，涉及201,006名患者。与正常体重相比，体重过轻是乳腺癌患者总生存期（OS）的一个危险因素（HR 1.15，95%CI 0.98 - 1.35；P = 0.08）。与正常体重相比，超重或肥胖是OS（HR 1.18，95%CI 1.14 - 1.23；P < 0.00001）、无病生存期（DFS）（HR 1.11，95%CI 1.08 - 1.13；P < 0.00001）、无复发生存期（RFS）（HR 1.14，95%CI 1.06 - 1.22；P = 0.03）和乳腺癌特异性生存期（BCSS）（HR 1.18，95%CI 1.11 - 1.26；P < 0.00001）的危险因素，但不是无进展生存期（PFS）的危险因素（HR 0.91，95%CI 0.76 - 1.10；P = 0.33）。值得注意的是，在亚组分析中，超重患者的PFS延长（HR 0.80，95%CI 0.64 - 0.99；P = 0.04），与肥胖人群相比，超重队列在OS（HR 1.11，95%CI 1.05 - 1.16；P < 0.00001）和DFS（HR 1.06，95%CI 1.03 - 1.10；P = 0.0004）方面存在显著差异，关联更强。此外，与HER-患者相比，HER +患者在OS（HR 1.23，95%CI 1.10 - 1.37；P = 0.0004）、RFS（HR 1.30，95%CI 1.03 - 1.64；P < 0.00001）和DFS（HR 1.10，95%CI 1.03 - 1.17；P = 0.003）方面具有更大的预测价值。
我们的荟萃分析结果揭示了BMI与乳腺癌预后的各种生存指标之间存在显著关联。这些发现为预测乳腺癌预后和实施更有效的治疗方法提供了坚实的基础。
