Body Mass Index at Diagnosis and Survival Among Colon Cancer Patients Enrolled in Clinical Trials of Adjuvant Chemotherapy
Identifieur interne : 000460 ( France/Analysis ); précédent : 000459; suivant : 000461Body Mass Index at Diagnosis and Survival Among Colon Cancer Patients Enrolled in Clinical Trials of Adjuvant Chemotherapy
Auteurs : Frank A. Sinicrope [États-Unis] ; Nathan R. Foster [États-Unis] ; Greg Yothers [États-Unis] ; Al Benson [États-Unis] ; Jean Francois Seitz [France] ; Roberto Labianca [Italie] ; Richard M. Goldberg [États-Unis] ; Aimery Degramont [France] ; Michael J. O'Connell [États-Unis] ; Daniel J. Sargent [États-Unis]Source :
- Cancer [ 0008-543X ] ; 2013.
Descripteurs français
- Pascal (Inist)
- Wicri :
- topic : Homme.
English descriptors
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Abstract
BACKGROUND: Although obesity is an established risk factor for developing colon cancer, its prognostic impact and relation to patient sex in colon cancer survivors remains unclear. METHODS: The authors examined the prognostic and predictive impact of the body mass index (BMI) in patients with stage II and III colon carcinoma (N = 25,291) within the Adjuvant Colon Cancer Endpoints (ACCENT) database. BMI was measured at enrollment in randomized trials of 5-fluorouracil-based adjuvant chemotherapy. Association of BMI with the time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS) were determined using Cox regression models. Statistical tests were 2-sided. RESULTS: During a median follow-up of 7.8 years, obese and underweight patients had significantly poorer survival compared with overweight and normal-weight patients. In a multivariable analysis, the adverse prognostic impact of BMI was observed among men but not among women (Pinteraction = .0129). Men with class 2 and 3 obesity (BMI >35.0 kg/m2) had a statistically significant reduction in DFS (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.01-1.33; P = .0297) compared with normal-weight patients. Underweight patients had a significantly shorter TTR and reduced DFS (HR, 1.18; 95% CI, 1.09-1.28; P < .0001) that was more significant among men (HR, 1.31; 95% CI, 1.15-1.50; P < .0001) than among women (HR, 1.11; 95% CI, 1.01-1.23; P = .0362; Pinteraction = .0340). BMI was not predictive of a benefit from adjuvant treatment. CONCLUSIONS: Obesity and underweight status were associated independently with inferior outcomes in patients with colon cancer who received treatment in adjuvant chemotherapy trials.
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Sinicrope</name><affiliation wicri:level="2"><inist:fA14 i1="01"><s1>Division of Oncology, Mayo Clinic and North Central Cancer Treatment Group</s1><s2>Rochester, Minnesota</s2><s3>USA</s3><sZ>1 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Foster, Nathan R" sort="Foster, Nathan R" uniqKey="Foster N" first="Nathan R." last="Foster">Nathan R. Foster</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Division of Biomedical Statistics and Informatics, Mayo Clinic and North Central Cancer Treatment Group</s1><s2>Rochester, Minnesota</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Minnesota</region></placeName></affiliation></author><author><name sortKey="Yothers, Greg" sort="Yothers, Greg" uniqKey="Yothers G" first="Greg" last="Yothers">Greg Yothers</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>National Surgery Adjuvant Breast and Bowel Project</s1><s2>Pittsburgh, Pennsylvania</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Benson, Al" sort="Benson, Al" uniqKey="Benson A" first="Al" last="Benson">Al Benson</name><affiliation wicri:level="2"><inist:fA14 i1="04"><s1>Eastern Cooperative Oncology Group</s1><s2>Philadelphia, Pennsylvania</s2><s3>USA</s3><sZ>4 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Francois Seitz, Jean" sort="Francois Seitz, Jean" uniqKey="Francois Seitz J" first="Jean" last="Francois Seitz">Jean Francois Seitz</name><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>French Society for Digestive Oncology, University of the Mediterranean</s1><s2>Marseilles</s2><s3>FRA</s3><sZ>5 aut.</sZ></inist:fA14><country>France</country><wicri:noRegion>Marseilles</wicri:noRegion><wicri:noRegion>University of the Mediterranean</wicri:noRegion><wicri:noRegion>Marseilles</wicri:noRegion></affiliation></author><author><name sortKey="Labianca, Roberto" sort="Labianca, Roberto" uniqKey="Labianca R" first="Roberto" last="Labianca">Roberto Labianca</name><affiliation wicri:level="1"><inist:fA14 i1="06"><s1>Unit of Medical Oncology, Riuniti Hospital</s1><s2>Bergamo</s2><s3>ITA</s3><sZ>6 aut.</sZ></inist:fA14><country>Italie</country><wicri:noRegion>Bergamo</wicri:noRegion></affiliation></author><author><name sortKey="Goldberg, Richard M" sort="Goldberg, Richard M" uniqKey="Goldberg R" first="Richard M." last="Goldberg">Richard M. Goldberg</name><affiliation wicri:level="2"><inist:fA14 i1="07"><s1>Cancer and Leukemia Group B</s1><s2>Chicago, Illinois</s2><s3>USA</s3><sZ>7 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Illinois</region></placeName></affiliation></author><author><name sortKey="Degramont, Aimery" sort="Degramont, Aimery" uniqKey="Degramont A" first="Aimery" last="Degramont">Aimery Degramont</name><affiliation wicri:level="3"><inist:fA14 i1="08"><s1>Multidisciplinary Cooperative Oncology Group</s1><s2>Paris</s2><s3>FRA</s3><sZ>8 aut.</sZ></inist:fA14><country>France</country><placeName><region type="region">Île-de-France</region><region type="old region">Île-de-France</region><settlement type="city">Paris</settlement></placeName></affiliation></author><author><name sortKey="O Connell, Michael J" sort="O Connell, Michael J" uniqKey="O Connell M" first="Michael J." last="O'Connell">Michael J. O'Connell</name><affiliation wicri:level="2"><inist:fA14 i1="03"><s1>National Surgery Adjuvant Breast and Bowel Project</s1><s2>Pittsburgh, Pennsylvania</s2><s3>USA</s3><sZ>3 aut.</sZ><sZ>9 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName></affiliation></author><author><name sortKey="Sargent, Daniel J" sort="Sargent, Daniel J" uniqKey="Sargent D" first="Daniel J." last="Sargent">Daniel J. Sargent</name><affiliation wicri:level="2"><inist:fA14 i1="02"><s1>Division of Biomedical Statistics and Informatics, Mayo Clinic and North Central Cancer Treatment Group</s1><s2>Rochester, Minnesota</s2><s3>USA</s3><sZ>2 aut.</sZ><sZ>10 aut.</sZ></inist:fA14><country>États-Unis</country><placeName><region type="state">Minnesota</region></placeName></affiliation></author></analytic><series><title level="j" type="main">Cancer</title><title level="j" type="abbreviated">Cancer</title><idno type="ISSN">0008-543X</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Cancer</title><title level="j" type="abbreviated">Cancer</title><idno type="ISSN">0008-543X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adjuvant treatment</term><term>Body mass index</term><term>Cancerology</term><term>Chemotherapy</term><term>Clinical trial</term><term>Colon cancer</term><term>Diagnosis</term><term>Human</term><term>Nutritional status</term><term>Obesity</term><term>Patient</term><term>Survival</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Indice masse corporelle</term><term>Diagnostic</term><term>Survie</term><term>Cancer du côlon</term><term>Homme</term><term>Malade</term><term>Chimiothérapie</term><term>Essai clinique</term><term>Traitement adjuvant</term><term>Obésité</term><term>Cancérologie</term><term>Etat nutritionnel</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Homme</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">BACKGROUND: Although obesity is an established risk factor for developing colon cancer, its prognostic impact and relation to patient sex in colon cancer survivors remains unclear. METHODS: The authors examined the prognostic and predictive impact of the body mass index (BMI) in patients with stage II and III colon carcinoma (N = 25,291) within the Adjuvant Colon Cancer Endpoints (ACCENT) database. BMI was measured at enrollment in randomized trials of 5-fluorouracil-based adjuvant chemotherapy. Association of BMI with the time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS) were determined using Cox regression models. Statistical tests were 2-sided. RESULTS: During a median follow-up of 7.8 years, obese and underweight patients had significantly poorer survival compared with overweight and normal-weight patients. In a multivariable analysis, the adverse prognostic impact of BMI was observed among men but not among women (P<sub>interaction </sub>= .0129). Men with class 2 and 3 obesity (BMI >35.0 kg/m<sup>2</sup>) had a statistically significant reduction in DFS (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.01-1.33; P = .0297) compared with normal-weight patients. Underweight patients had a significantly shorter TTR and reduced DFS (HR, 1.18; 95% CI, 1.09-1.28; P < .0001) that was more significant among men (HR, 1.31; 95% CI, 1.15-1.50; P < .0001) than among women (HR, 1.11; 95% CI, 1.01-1.23; P = .0362; P<sub>interaction</sub> = .0340). BMI was not predictive of a benefit from adjuvant treatment. CONCLUSIONS: Obesity and underweight status were associated independently with inferior outcomes in patients with colon cancer who received treatment in adjuvant chemotherapy trials.</div></front></TEI><affiliations><list><country><li>France</li><li>Italie</li><li>États-Unis</li></country><region><li>Illinois</li><li>Minnesota</li><li>Pennsylvanie</li><li>Île-de-France</li></region><settlement><li>Paris</li></settlement></list><tree><country name="États-Unis"><region name="Minnesota"><name sortKey="Sinicrope, Frank A" sort="Sinicrope, Frank A" uniqKey="Sinicrope F" first="Frank A." last="Sinicrope">Frank A. Sinicrope</name></region><name sortKey="Benson, Al" sort="Benson, Al" uniqKey="Benson A" first="Al" last="Benson">Al Benson</name><name sortKey="Foster, Nathan R" sort="Foster, Nathan R" uniqKey="Foster N" first="Nathan R." last="Foster">Nathan R. Foster</name><name sortKey="Goldberg, Richard M" sort="Goldberg, Richard M" uniqKey="Goldberg R" first="Richard M." last="Goldberg">Richard M. Goldberg</name><name sortKey="O Connell, Michael J" sort="O Connell, Michael J" uniqKey="O Connell M" first="Michael J." last="O'Connell">Michael J. O'Connell</name><name sortKey="Sargent, Daniel J" sort="Sargent, Daniel J" uniqKey="Sargent D" first="Daniel J." last="Sargent">Daniel J. Sargent</name><name sortKey="Yothers, Greg" sort="Yothers, Greg" uniqKey="Yothers G" first="Greg" last="Yothers">Greg Yothers</name></country><country name="France"><noRegion><name sortKey="Francois Seitz, Jean" sort="Francois Seitz, Jean" uniqKey="Francois Seitz J" first="Jean" last="Francois Seitz">Jean Francois Seitz</name></noRegion><name sortKey="Degramont, Aimery" sort="Degramont, Aimery" uniqKey="Degramont A" first="Aimery" last="Degramont">Aimery Degramont</name></country><country name="Italie"><noRegion><name sortKey="Labianca, Roberto" sort="Labianca, Roberto" uniqKey="Labianca R" first="Roberto" last="Labianca">Roberto Labianca</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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