LymphedemaV1, Main, Exploration, bibRecord, 005584

The Effects of Body Mass Index on Complications and Survival Outcomes in Patients with Cervical Carcinoma Undergoing Curative Chemoradiation Therapy

Identifieur interne : 005584 ( Main/Exploration ); précédent : 005583; suivant : 005585

The Effects of Body Mass Index on Complications and Survival Outcomes in Patients with Cervical Carcinoma Undergoing Curative Chemoradiation Therapy

Auteurs : Nora T. Kizer [États-Unis] ; Premal H. Thaker [États-Unis] ; Feng Gao [États-Unis] ; Israel Zighelboim [États-Unis] ; Matthew A. Powell [États-Unis] ; Janet S. Rader [États-Unis] ; David G. Mutch [États-Unis] ; Perry W. Grigsby [États-Unis]

Source :

Cancer [ 0008-543X ] ; 2010.

RBID : PMC:4080792

Descripteurs français

English descriptors

KwdEn :
- Adult, Aged, Aged, 80 and over, Antineoplastic Combined Chemotherapy Protocols (adverse effects), Antineoplastic Combined Chemotherapy Protocols (therapeutic use), Body Mass Index, Carcinoma, Squamous Cell (complications), Carcinoma, Squamous Cell (mortality), Carcinoma, Squamous Cell (therapy), Combined Modality Therapy, Female, Follow-Up Studies, Humans, Middle Aged, Obesity (complications), Obesity (mortality), Radiotherapy (adverse effects), Radiotherapy (methods), Remission Induction, Survival Analysis, Treatment Outcome, Uterine Cervical Neoplasms (complications), Uterine Cervical Neoplasms (mortality), Uterine Cervical Neoplasms (therapy), Young Adult.
MESH :
- adverse effects : Antineoplastic Combined Chemotherapy Protocols, Radiotherapy.
- complications : Carcinoma, Squamous Cell, Obesity, Uterine Cervical Neoplasms.
- methods : Radiotherapy.
- mortality : Carcinoma, Squamous Cell, Obesity, Uterine Cervical Neoplasms.
- therapeutic use : Antineoplastic Combined Chemotherapy Protocols.
- therapy : Carcinoma, Squamous Cell, Uterine Cervical Neoplasms.
- Adult, Aged, Aged, 80 and over, Body Mass Index, Combined Modality Therapy, Female, Follow-Up Studies, Humans, Middle Aged, Remission Induction, Survival Analysis, Treatment Outcome, Young Adult.

Abstract

Background

The effect of body mass index (BMI) on treatment outcomes for patients with locally advanced cervical carcinoma undergoing definitive chemoradiation is unclear.

Methods

This study cohort included all cervical carcinoma patients (n = 404) with stage IB₁ and positive lymph nodes or stage ≥ IB₂ treated at our facility from January 1998 to January 2008. Mean follow-up time was 47.2 months. BMI was calculated using the National Institute of Health online calculator. BMI categories were created according to the World Health Organization classification system. Primary outcomes were overall survival, disease free survival, and complication rate. Univariate and multivariate analyses were performed. Kaplan-Meier survival curves were generated and compared using Cox proportional hazard models.

Results

On multivariate analysis, when compared to normal weight subjects (18.5-24.9 kg/m²), a BMI < 18.5 kg/m² was associated with decreased overall survival (HR 2.37, 95% CI 1.28 - 4.38, p<0.01). The 5-year overall survivals were 33%, 60%, and 68% for a BMI < 18.5 kg/m², BMI 18.5-24.9 kg/m², and a BMI > 24.9 kg/m² respectively. A BMI < 18.5 kg/m² was associated with increased risk for grade 3 or 4 complications when compared to patients with a BMI > 24.9 kg/m² (radiation enteritis: 16.7% vs. 13.6 % p= 0.03, fistula: 11.1% vs. 8.8% p= 0.05, bowel obstruction 33.3% vs. 4.4% p< 0.001, lymphedema: 5.6% vs. 1.2% p=0.02).

Conclusions

Underweight patients (BMI < 18.5 kg/m²) with locally advanced cervical cancer have diminished overall survival and more complications than normal weight and obese patients.

Url:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4080792

DOI: 10.1002/cncr.25544
PubMed: 20945318
PubMed Central: 4080792

Affiliations:

Le document en format XML

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<term>Aged</term>
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<term>Antineoplastic Combined Chemotherapy Protocols (therapeutic use)</term>
<term>Body Mass Index</term>
<term>Carcinoma, Squamous Cell (complications)</term>
<term>Carcinoma, Squamous Cell (mortality)</term>
<term>Carcinoma, Squamous Cell (therapy)</term>
<term>Combined Modality Therapy</term>
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<term>Follow-Up Studies</term>
<term>Humans</term>
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<term>Obesity (complications)</term>
<term>Obesity (mortality)</term>
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<term>Uterine Cervical Neoplasms (therapy)</term>
<term>Young Adult</term>
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<term>Association thérapeutique</term>
<term>Carcinome épidermoïde ()</term>
<term>Carcinome épidermoïde (mortalité)</term>
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<term>Humains</term>
<term>Indice de masse corporelle</term>
<term>Induction de rémission</term>
<term>Jeune adulte</term>
<term>Obésité ()</term>
<term>Obésité (mortalité)</term>
<term>Protocoles de polychimiothérapie antinéoplasique (effets indésirables)</term>
<term>Protocoles de polychimiothérapie antinéoplasique (usage thérapeutique)</term>
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<term>Radiothérapie (effets indésirables)</term>
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<term>Tumeurs du col de l'utérus (mortalité)</term>
<term>Études de suivi</term>
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<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Radiotherapy</term>
</keywords>
<keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Carcinoma, Squamous Cell</term>
<term>Obesity</term>
<term>Uterine Cervical Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="mortalité" xml:lang="fr"><term>Carcinome épidermoïde</term>
<term>Obésité</term>
<term>Tumeurs du col de l'utérus</term>
</keywords>
<keywords scheme="MESH" qualifier="therapeutic use" xml:lang="en"><term>Antineoplastic Combined Chemotherapy Protocols</term>
</keywords>
<keywords scheme="MESH" qualifier="therapy" xml:lang="en"><term>Carcinoma, Squamous Cell</term>
<term>Uterine Cervical Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Protocoles de polychimiothérapie antinéoplasique</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Body Mass Index</term>
<term>Combined Modality Therapy</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Middle Aged</term>
<term>Remission Induction</term>
<term>Survival Analysis</term>
<term>Treatment Outcome</term>
<term>Young Adult</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Analyse de survie</term>
<term>Association thérapeutique</term>
<term>Carcinome épidermoïde</term>
<term>Femelle</term>
<term>Humains</term>
<term>Indice de masse corporelle</term>
<term>Induction de rémission</term>
<term>Jeune adulte</term>
<term>Obésité</term>
<term>Radiothérapie</term>
<term>Résultat thérapeutique</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Tumeurs du col de l'utérus</term>
<term>Études de suivi</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">The effect of body mass index (BMI) on treatment outcomes for patients with locally advanced cervical carcinoma undergoing definitive chemoradiation is unclear.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">This study cohort included all cervical carcinoma patients (n = 404) with stage IB<sub>1</sub>
 and positive lymph nodes or stage ≥ IB<sub>2</sub>
 treated at our facility from January 1998 to January 2008. Mean follow-up time was 47.2 months. BMI was calculated using the National Institute of Health online calculator. BMI categories were created according to the World Health Organization classification system. Primary outcomes were overall survival, disease free survival, and complication rate. Univariate and multivariate analyses were performed. Kaplan-Meier survival curves were generated and compared using Cox proportional hazard models.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">On multivariate analysis, when compared to normal weight subjects (18.5-24.9 kg/m<sup>2</sup>
), a BMI < 18.5 kg/m<sup>2</sup>
 was associated with decreased overall survival (HR 2.37, 95% CI 1.28 - 4.38, p<0.01). The 5-year overall survivals were 33%, 60%, and 68% for a BMI < 18.5 kg/m<sup>2</sup>
, BMI 18.5-24.9 kg/m<sup>2</sup>
, and a BMI > 24.9 kg/m<sup>2</sup>
 respectively. A BMI < 18.5 kg/m<sup>2</sup>
 was associated with increased risk for grade 3 or 4 complications when compared to patients with a BMI > 24.9 kg/m<sup>2</sup>
 (radiation enteritis: 16.7% vs. 13.6 % p= 0.03, fistula: 11.1% vs. 8.8% p= 0.05, bowel obstruction 33.3% vs. 4.4% p< 0.001, lymphedema: 5.6% vs. 1.2% p=0.02).</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">Underweight patients (BMI < 18.5 kg/m<sup>2</sup>
) with locally advanced cervical cancer have diminished overall survival and more complications than normal weight and obese patients.</p>
</sec>
</div>
</front>
</TEI>
<affiliations><list><country><li>États-Unis</li>
</country>
<region><li>Missouri (État)</li>
<li>Wisconsin</li>
</region>
</list>
<tree><country name="États-Unis"><region name="Missouri (État)"><name sortKey="Kizer, Nora T" sort="Kizer, Nora T" uniqKey="Kizer N" first="Nora T." last="Kizer">Nora T. Kizer</name>
</region>
<name sortKey="Gao, Feng" sort="Gao, Feng" uniqKey="Gao F" first="Feng" last="Gao">Feng Gao</name>
<name sortKey="Grigsby, Perry W" sort="Grigsby, Perry W" uniqKey="Grigsby P" first="Perry W." last="Grigsby">Perry W. Grigsby</name>
<name sortKey="Grigsby, Perry W" sort="Grigsby, Perry W" uniqKey="Grigsby P" first="Perry W." last="Grigsby">Perry W. Grigsby</name>
<name sortKey="Grigsby, Perry W" sort="Grigsby, Perry W" uniqKey="Grigsby P" first="Perry W." last="Grigsby">Perry W. Grigsby</name>
<name sortKey="Grigsby, Perry W" sort="Grigsby, Perry W" uniqKey="Grigsby P" first="Perry W." last="Grigsby">Perry W. Grigsby</name>
<name sortKey="Kizer, Nora T" sort="Kizer, Nora T" uniqKey="Kizer N" first="Nora T." last="Kizer">Nora T. Kizer</name>
<name sortKey="Mutch, David G" sort="Mutch, David G" uniqKey="Mutch D" first="David G." last="Mutch">David G. Mutch</name>
<name sortKey="Mutch, David G" sort="Mutch, David G" uniqKey="Mutch D" first="David G." last="Mutch">David G. Mutch</name>
<name sortKey="Powell, Matthew A" sort="Powell, Matthew A" uniqKey="Powell M" first="Matthew A." last="Powell">Matthew A. Powell</name>
<name sortKey="Powell, Matthew A" sort="Powell, Matthew A" uniqKey="Powell M" first="Matthew A." last="Powell">Matthew A. Powell</name>
<name sortKey="Rader, Janet S" sort="Rader, Janet S" uniqKey="Rader J" first="Janet S." last="Rader">Janet S. Rader</name>
<name sortKey="Thaker, Premal H" sort="Thaker, Premal H" uniqKey="Thaker P" first="Premal H." last="Thaker">Premal H. Thaker</name>
<name sortKey="Thaker, Premal H" sort="Thaker, Premal H" uniqKey="Thaker P" first="Premal H." last="Thaker">Premal H. Thaker</name>
<name sortKey="Zighelboim, Israel" sort="Zighelboim, Israel" uniqKey="Zighelboim I" first="Israel" last="Zighelboim">Israel Zighelboim</name>
<name sortKey="Zighelboim, Israel" sort="Zighelboim, Israel" uniqKey="Zighelboim I" first="Israel" last="Zighelboim">Israel Zighelboim</name>
</country>
</tree>
</affiliations>
</record>

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The Effects of Body Mass Index on Complications and Survival Outcomes in Patients with Cervical Carcinoma Undergoing Curative Chemoradiation Therapy

The Effects of Body Mass Index on Complications and Survival Outcomes in Patients with Cervical Carcinoma Undergoing Curative Chemoradiation Therapy

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