Prognostic Value of Body Mass Index in Stage II/III Colon Cancer: Posthoc Analysis From the TOSCA Trial |
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| Institution: | 1. Department of Medical Oncology, San Bortolo General Hospital, Vicenza, Italy;2. Medical Oncology Unit, San Carlo Hospital, Potenza, Italy;3. Medical Oncology Unit 1, Istituto Oncologico Veneto-IOV IRCCS, Padova, Italy;4. Medical Oncology Unit, Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy;5. Medical Oncology Unit, AUSL—IRCCS, Reggio Emilia, Italy;6. Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, Istituto Europeo di Oncologia—IRCCS, Milano, Italy;7. Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy;8. Medical Oncology Unit Sant''Andrea Hospital, Sapienza University of Rome and IRCCS Istituto Dermopatico dell''Immacolata, Rome, Italy;9. Methodology for Clinical Research Laboratory, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy;10. Medical Oncology Unit San Gerardo Hospital, Monza, Italy;11. Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy;12. Medical Oncology Unit, Azienda Ospedaliera San Paolo, Milano, Italy;13. Medical Oncology Unit Università Federico II, Napoli, Italy;14. Medical Oncology Unit IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (FO), Italy;15. Medical Oncology Unit Azienda USL Romagna, Cattolica, Rimini, Italy;16. Medical Oncology Unit Ospedale Antonio Perrino, Brindisi, Italy;17. Medical Oncology Unit1, Fondazione Istituto Nazionale Tumori—IRCCS, Milano, Italy;18. Medical Oncology, University Hospital and University of Cagliari, Cagliari, Italy;19. Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy;20. Medical Oncology Unit, IRCCS San Martino—IST-Genova, Genova, Italy;21. Cancer Center ASST Papa Giovanni XXIII, Bergamo, Italy;1. Division of Colon and Rectal Surgery, Department of Surgery, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea;2. Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea;1. Department of Medical Oncology, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province, China;2. State Key Laboratory of Esophageal Cancer Prevention & Treatment, Zhengzhou University, Zhengzhou, Henan Province, China;3. Henan Engineering Research Center of Precision Therapy of Gastrointestinal Cancer, Zhengzhou, Henan Province, China;4. Zhengzhou Key Laboratory for Precision Therapy of Gastrointestinal Cancer, Zhengzhou, Henan Province, China;5. Department of General Surgery, Affiliated Cancer Hospital of Zhengzhou University, Henan Cancer Hospital, Zhengzhou, Henan Province, China;1. Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Japan;2. International Research Promotion Office, National Cancer Center Hospital East, Kashiwa, Japan;3. Translational Research Support Office, National Cancer Center Hospital East, Kashiwa, Japan;4. Department of Surgery and Science, Graduate School of Medical Science, Kyushu University, Fukuoka, Japan;5. Division for the Promotion of Drug and Diagnostic Development, National Cancer Center Hospital East, Kashiwa, Japan;1. Amsterdam UMC location University of Amsterdam, Center for Experimental and Molecular Medicine, Laboratory for Experimental Oncology and Radiobiology, Amsterdam, The Netherlands;2. Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands;3. Oncode Institute, Utrecht, The Netherlands;4. Clinical Research Department, Netherlands Comprehensive Cancer Center (IKNL), Nijmegen, The Netherlands;5. Amsterdam UMC location University of Amsterdam, Department of Medical Oncology, Amsterdam, The Netherlands;6. Flevohospital, Department of Internal Medicine, Almere, The Netherlands;7. Amsterdam UMC location University of Amsterdam, Amsterdam Gastroenterology & Metabolism, Amsterdam, The Netherlands;8. Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Pathology, Cancer Center Amsterdam, Amsterdam, The Netherlands;9. Amsterdam UMC location University of Amsterdam, Department of Pathology, Amsterdam, The Netherlands;10. Radboud Institute for Molecular Life Sciences, Department of Pathology, Radboud University Medical Center, Nijmegen, The Netherlands;11. Department of Medical Oncology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands;12. Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center, Utrecht University, Utrecht, The Netherlands;1. Moores Cancer Center, La Jolla, CA;2. Stanford Medical Center, Palo Alto, CA;3. Kaiser Permanente, Honolulu, HI;4. Clinical Trials Innovations, Mountain View, CA;5. EpicentRx, Torrey Pines, CA |
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| Abstract: | BackgroundHigh body mass index (BMI) plays a key role in the development of colon cancer (CC). Our post-hoc analysis from the TOSCA trial analyzed the association between BMI and survival outcomes in terms of relapse-free survival (RFS) and overall survival (OS) in stage II/III CC patients.Patients and methodsPatients enrolled in the TOSCA trial between 2007-2013 with BMI data entered the study. The prognostic impact of BMI on survival outcomes was investigated through uni- and multivariable Cox regression analyses.ResultsOverall, 1455 patients with stage II/III CC patients were included. The median follow-up was of 61.5 months; 16.1% of patients relapsed, 11.2% died and 19.5% patients relapsed or died. No impact of BMI on RFS was detected at univariate or multivariable analyses. By univariate analysis for OS, a significantly impact of a BMI > 30 kg/m2 was reported (HR >30 vs <25] 1.57, 95% CI 1.00-2.47, p = 0.049; HR >30 vs <30] 1.55, 95% CI 1.01-2.37, p = 0.045). Multivariable analyses did not confirm this data. In the subgroup of stage III patients, a negative survival impact of BMI was found in univariate and multivariable models both for RFS and for OS.ConclusionsIn our study, obesity with BMI > 30 kg/m2 was an independent prognostic factor for RFS and OS in CC patients treated with adjuvant chemotherapy, regardless of its duration (3 or 6 months). However, the prognostic impact of adiposity and body composition measurement should be considered to better classify patients with high visceral fat and refine their risk assessment. |
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| Keywords: | BMI"} {"#name":"keyword" "$":{"id":"pc_VHHidkKbGV"} "$$":[{"#name":"text" "_":"Body Mass Index |
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