Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials.

Autor: Aparicio T; Gastroenterology Department, CHU Saint Louis, APHP, Paris, France; University Paris 7, Sorbonne Paris Cité, Paris, France. Electronic address: thomas.aparicio@aphp.fr., Ducreux M; Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France., Faroux R; Gastroenterology Department, CH La Roche sur Yon, La Roche sur Yon, France., Barbier E; Statistics Department, Fédération Francophone de Cancérologie Digestive, Dijon, France; INSERM UMR 1231, Dijon, France., Manfredi S; Univ. Bourgogne Franche-Comté, INSERM UMR1231, Gastroenterology Department, CHU de Dijon, Dijon, France., Lecomte T; Gastroenterology Department, CHU Trousseau, Tours, France., Etienne PL; Oncology Department, CARIO, HPCA, Plérin, France., Bedenne L; Univ. Bourgogne Franche-Comté, INSERM UMR1231, Gastroenterology Department, CHU de Dijon, Dijon, France., Bennouna J; Oncology Department, Institut de Cancérologie de L'Ouest, Saint Herblay, France., Phelip JM; Gastroenterology Department, CHU Saint Etienne - Hôpital Nord, Saint Priest en Jarez, France., François E; Gastroenterology Department, Centre Antoine Lacassagne, Nice, France., Michel P; Gastroenterology Department, Rouen University Hospital, CHU Charles Nicolle, Rouen, France., Legoux JL; Hepato-Gastroenterology and Digestive Oncology Department, CHR La Source, Orléans, France., Gasmi M; Gastroenterology Department, CHU Hôpital Nord, Marseille, France., Breysacher G; Gastroenterology Department, CH Pasteur, Colmar, France., Rougier P; Gastroenterology Department, CHU de Nantes, Nantes, France., De Gramont A; Oncology Department, Hôpital Franco-Britanique, Levallois Perret, France., Lepage C; Univ. Bourgogne Franche-Comté, INSERM UMR1231, Gastroenterology Department, CHU de Dijon, Dijon, France., Bouché O; Digestive Oncology Department, CHU Robert Debré, Reims, France., Seitz JF; Digestive Oncology Department, CHU La Timone, APHM, Aix-Marseille Univ, Marseille, France.
Jazyk: angličtina
Zdroj: European journal of cancer (Oxford, England : 1990) [Eur J Cancer] 2018 Jul; Vol. 98, pp. 1-9. Date of Electronic Publication: 2018 May 26.
DOI: 10.1016/j.ejca.2018.03.031
Abstrakt: Background: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in early-stage colorectal cancer (CRC), and low BMI was associated with worse prognosis in metastatic CRC (mCRC). We aimed to assess efficacy outcomes according to BMI.
Patients and Methods: A pooled analysis of individual data from 2085 patients enrolled in eight FFCD first-line mCRC trials from 1991 to 2013 was performed. Comparisons were made according to the BMI cut-off: Obese (BMI ≥30), overweight patients (BMI ≥ 25), normal BMI patients (BMI: 18.5-24) and thin patients (BMI <18.5). Interaction tests were performed between BMI effect and sex, age and the addition of antiangiogenics to chemotherapy.
Results: The rate of BMI ≥25 patients was 41.5%, ranging from 37.6% (1991-1999 period) to 41.5% (2000-2006 period) and 44.8% (2007-2013 period). Comparison of overweight patients versus normal BMI range patients revealed a significant improvement of median overall survival (OS) (18.5 versus 16.3 months, HR = 0.88 [0.80-0.98] p = 0.02) and objective response rate (ORR) (42% versus 36% OR = 1.23 [1.01-1.50] p = 0.04) but a comparable median progression-free survival (PFS) (7.8 versus 7.2 months, HR = 0.96 [0.87-1.05] p = 0.35). Subgroup analyses revealed that overweight was significantly associated with better OS in men. OS and PFS were significantly shorter in thin patients.
Conclusion: Overweight patients had a prolonged OS compared with normal weight patients with mCRC. The association of overweight with better OS was only observed in men. The pejorative prognosis of BMI <18.5 was confirmed.
(Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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