Impact of body fat distribution on neoadjuvant chemotherapy outcomes in advanced breast cancer patients.

Autor: Iwase, Toshiaki, Sangai, Takafumi, Nagashima, Takeshi, Sakakibara, Masahiro, Sakakibara, Junta, Hayama, Shouko, Ishigami, Emi, Masuda, Takahito, Miyazaki, Masaru
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Zdroj: Cancer Medicine; Jan2016, Vol. 5 Issue 1, p41-48, 8p
Abstrakt: Obesity is known to decrease the efficacy of neoadjuvant chemotherapy ( NAC) against breast cancer; however, the relationship between actual body composition and NAC outcomes remains unknown. Therefore, we determined the effect of body composition on NAC outcomes. A total of 172 advanced breast cancer patients who underwent surgery after NAC were retrospectively analyzed. Body composition parameters including abdominal circumference ( AC), subcutaneous fat area ( SFA), visceral fat area ( VFA), and skeletal muscle area ( SMA) were calculated using computed tomography volume-analyzing software. VFA/ SFA ratio was used to evaluate visceral obesity. The associations of body composition parameters with pathological complete remission ( pCR) and survival were analyzed. AC, SFA, and VFA were significantly correlated with body mass index ( BMI) (all P < 0.05; r = 0.82, r = 0.71, and r = 0.78, respectively). AC, SFA, and VFA increased significantly and SMA decreased significantly after menopause (all P < 0.05). VFA/ SFA ratio increased significantly after menopause, even though BMI remained unchanged. Body composition parameters were not associated with pCR. Distant disease-free survival ( DDFS) was significantly worse in the high VFA group than in the low VFA group ( P < 0.05). Furthermore, in the high VFA group, postmenopausal patients had significantly shorter DDFS than premenopausal patients ( P < 0.05). VFA was independently associated with DDFS in the multivariate analysis ( P < 0.05). High visceral fat is associated with worse NAC outcomes in breast cancer patients, especially postmenopausal patients. Interventions targeting visceral fat accumulation will likely improve NAC outcomes. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index
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