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The Reality of Lung Cancer Paradox: The Impact of Body Mass Index on Long-Term Survival of Resected Lung Cancer. A French Nationwide Analysis from the Epithor Database
SIMPLE SUMMARY: It is commonly believed that obesity increases the risk of cancers and lowers the possibility of cure of patients with proven cancers. In recent years, this traditional view has been challenged by the hypothesis of an ‘obesity paradox’, which refers to a better prognosis in obese pat...
Autores principales: | , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471205/ https://www.ncbi.nlm.nih.gov/pubmed/34572801 http://dx.doi.org/10.3390/cancers13184574 |
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author | Alifano, Marco Daffré, Elisa Iannelli, Antonio Brouchet, Laurent Falcoz, Pierre Emmanuel Le Pimpec Barthes, Françoise Bernard, Alain Pages, Pierre Benoit Thomas, Pascal Alexandre Dahan, Marcel Porcher, Raphael |
author_facet | Alifano, Marco Daffré, Elisa Iannelli, Antonio Brouchet, Laurent Falcoz, Pierre Emmanuel Le Pimpec Barthes, Françoise Bernard, Alain Pages, Pierre Benoit Thomas, Pascal Alexandre Dahan, Marcel Porcher, Raphael |
author_sort | Alifano, Marco |
collection | PubMed |
description | SIMPLE SUMMARY: It is commonly believed that obesity increases the risk of cancers and lowers the possibility of cure of patients with proven cancers. In recent years, this traditional view has been challenged by the hypothesis of an ‘obesity paradox’, which refers to a better prognosis in obese patients with some specific cancers, compared to normal/underweight patients. In this study, we assessed, in a nationwide dataset, the prognostic role of preoperative BMI on postoperative outcomes in patients undergoing curative lung resection for non-small-cell lung cancer (NSCLC) and found that BMI is a strong and independent predictor of long-term survival. ABSTRACT: Obesity could have a protective effect in patients with lung cancer. We assessed the prognostic role of preoperative BMI on survival in patients who underwent lung resection for NSCLC. A total of 54,631 consecutive patients with resectable lung cancer within a 15-year period were extracted from Epithor (the French Society of Thoracic and Cardiovascular Surgery database). Patient subgroups were defined according to body mass index (BMI): underweight (BMI < 18.5 kg/m(2)), normal weight (18.5 ≤ BMI < 25 kg/m(2)), overweight (25 ≤ BMI < 30 kg/m(2)), and obese (BMI ≥ 30 kg/m(2)). Underweight was associated with lower survival (unadjusted HRs 1.24 (1.16–1.33)) compared to normal weight, whereas overweight and obesity were associated with improved survival (0.95 (0.92–0.98) and 0.88 (0.84–0.92), respectively). The impact of BMI was confirmed when stratifying for sex or Charlson comorbidities index (CCI). Among patients with obesity, a higher BMI was associated with improved survival. After adjusting for period of study, age, sex, WHO performance status, CCI, side of tumor, extent of resection, histologic type, and stage of disease, the HRs for underweight, overweight, and obesity were 1.51 (1.41–1.63), 0.84 (0.81–0.87), and 0.80 (0.76–0.84), respectively. BMI is a strong and independent predictor of survival in patients undergoing surgery for NSCLC. |
format | Online Article Text |
id | pubmed-8471205 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-84712052021-09-27 The Reality of Lung Cancer Paradox: The Impact of Body Mass Index on Long-Term Survival of Resected Lung Cancer. A French Nationwide Analysis from the Epithor Database Alifano, Marco Daffré, Elisa Iannelli, Antonio Brouchet, Laurent Falcoz, Pierre Emmanuel Le Pimpec Barthes, Françoise Bernard, Alain Pages, Pierre Benoit Thomas, Pascal Alexandre Dahan, Marcel Porcher, Raphael Cancers (Basel) Article SIMPLE SUMMARY: It is commonly believed that obesity increases the risk of cancers and lowers the possibility of cure of patients with proven cancers. In recent years, this traditional view has been challenged by the hypothesis of an ‘obesity paradox’, which refers to a better prognosis in obese patients with some specific cancers, compared to normal/underweight patients. In this study, we assessed, in a nationwide dataset, the prognostic role of preoperative BMI on postoperative outcomes in patients undergoing curative lung resection for non-small-cell lung cancer (NSCLC) and found that BMI is a strong and independent predictor of long-term survival. ABSTRACT: Obesity could have a protective effect in patients with lung cancer. We assessed the prognostic role of preoperative BMI on survival in patients who underwent lung resection for NSCLC. A total of 54,631 consecutive patients with resectable lung cancer within a 15-year period were extracted from Epithor (the French Society of Thoracic and Cardiovascular Surgery database). Patient subgroups were defined according to body mass index (BMI): underweight (BMI < 18.5 kg/m(2)), normal weight (18.5 ≤ BMI < 25 kg/m(2)), overweight (25 ≤ BMI < 30 kg/m(2)), and obese (BMI ≥ 30 kg/m(2)). Underweight was associated with lower survival (unadjusted HRs 1.24 (1.16–1.33)) compared to normal weight, whereas overweight and obesity were associated with improved survival (0.95 (0.92–0.98) and 0.88 (0.84–0.92), respectively). The impact of BMI was confirmed when stratifying for sex or Charlson comorbidities index (CCI). Among patients with obesity, a higher BMI was associated with improved survival. After adjusting for period of study, age, sex, WHO performance status, CCI, side of tumor, extent of resection, histologic type, and stage of disease, the HRs for underweight, overweight, and obesity were 1.51 (1.41–1.63), 0.84 (0.81–0.87), and 0.80 (0.76–0.84), respectively. BMI is a strong and independent predictor of survival in patients undergoing surgery for NSCLC. MDPI 2021-09-12 /pmc/articles/PMC8471205/ /pubmed/34572801 http://dx.doi.org/10.3390/cancers13184574 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Alifano, Marco Daffré, Elisa Iannelli, Antonio Brouchet, Laurent Falcoz, Pierre Emmanuel Le Pimpec Barthes, Françoise Bernard, Alain Pages, Pierre Benoit Thomas, Pascal Alexandre Dahan, Marcel Porcher, Raphael The Reality of Lung Cancer Paradox: The Impact of Body Mass Index on Long-Term Survival of Resected Lung Cancer. A French Nationwide Analysis from the Epithor Database |
title | The Reality of Lung Cancer Paradox: The Impact of Body Mass Index on Long-Term Survival of Resected Lung Cancer. A French Nationwide Analysis from the Epithor Database |
title_full | The Reality of Lung Cancer Paradox: The Impact of Body Mass Index on Long-Term Survival of Resected Lung Cancer. A French Nationwide Analysis from the Epithor Database |
title_fullStr | The Reality of Lung Cancer Paradox: The Impact of Body Mass Index on Long-Term Survival of Resected Lung Cancer. A French Nationwide Analysis from the Epithor Database |
title_full_unstemmed | The Reality of Lung Cancer Paradox: The Impact of Body Mass Index on Long-Term Survival of Resected Lung Cancer. A French Nationwide Analysis from the Epithor Database |
title_short | The Reality of Lung Cancer Paradox: The Impact of Body Mass Index on Long-Term Survival of Resected Lung Cancer. A French Nationwide Analysis from the Epithor Database |
title_sort | reality of lung cancer paradox: the impact of body mass index on long-term survival of resected lung cancer. a french nationwide analysis from the epithor database |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471205/ https://www.ncbi.nlm.nih.gov/pubmed/34572801 http://dx.doi.org/10.3390/cancers13184574 |
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