Prognostic Validation of the Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) Index in Inoperable Non–Small-Cell Lung Cancer

To investigate the prognostic utility of the body mass index, severity of airflow obstruction, measures of exertional dyspnea, and exercise capacity (BODE) index in patients with inoperable non–small-cell lung cancer (NSCLC). One hundred consecutive patients with inoperable NSCLC and performance sta...

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Veröffentlicht in:Journal of thoracic oncology 2013-12, Vol.8 (12), p.1545-1550
Hauptverfasser: Denehy, Linda, Hornsby, Whitney E., Herndon, James E., Thomas, Samantha, Ready, Neal E., Granger, Catherine L., Valera, Lauren, Kenjale, Aarti A., Eves, Neil D., Jones, Lee W.
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container_issue 12
container_start_page 1545
container_title Journal of thoracic oncology
container_volume 8
creator Denehy, Linda
Hornsby, Whitney E.
Herndon, James E.
Thomas, Samantha
Ready, Neal E.
Granger, Catherine L.
Valera, Lauren
Kenjale, Aarti A.
Eves, Neil D.
Jones, Lee W.
description To investigate the prognostic utility of the body mass index, severity of airflow obstruction, measures of exertional dyspnea, and exercise capacity (BODE) index in patients with inoperable non–small-cell lung cancer (NSCLC). One hundred consecutive patients with inoperable NSCLC and performance status 0 to 3 completed pulmonary function testing, the modified Medical Research Council dyspnea scale, a 6-minute walk test, and body mass index—the multidimensional 10-point BODE index. Cox proportional models were used to estimate the risk of all-cause mortality according to the BODE index with or without adjustment for traditional prognostic factors. Median follow-up was 31.5 months; 61 deaths (61%) were reported during this period. There was a significant univariate association between the BODE index score and mortality (adjusted ptrend = 0.027). Compared with patients with a BODE index of 0, the adjusted hazard ratio for risk of death was 1.37 (95% confidence interval [CI], 0.74–2.55) for a BODE index of 1, 1.22 (95% CI, 0.45–3.25) for a BODE index of 2, and 2.44 (95% CI, 1.19–4.99) for a BODE index more than 2. The BODE index provided incremental prognostic information beyond that provided traditional markers of prognosis (adjusted ptrend = 0.051). Every one-point increase in the BODE index, the risk of death increased by 25% (hazard ratio = 1.25; 95% CI, 1.27–4.64). The BODE index is a strong independent predictor of survival in inoperable NSCLC beyond traditional risk factors. Use of this multidimensional tool may improve risk stratification and prognostication in NSCLC.
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One hundred consecutive patients with inoperable NSCLC and performance status 0 to 3 completed pulmonary function testing, the modified Medical Research Council dyspnea scale, a 6-minute walk test, and body mass index—the multidimensional 10-point BODE index. Cox proportional models were used to estimate the risk of all-cause mortality according to the BODE index with or without adjustment for traditional prognostic factors. Median follow-up was 31.5 months; 61 deaths (61%) were reported during this period. There was a significant univariate association between the BODE index score and mortality (adjusted ptrend = 0.027). Compared with patients with a BODE index of 0, the adjusted hazard ratio for risk of death was 1.37 (95% confidence interval [CI], 0.74–2.55) for a BODE index of 1, 1.22 (95% CI, 0.45–3.25) for a BODE index of 2, and 2.44 (95% CI, 1.19–4.99) for a BODE index more than 2. 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The BODE index provided incremental prognostic information beyond that provided traditional markers of prognosis (adjusted ptrend = 0.051). Every one-point increase in the BODE index, the risk of death increased by 25% (hazard ratio = 1.25; 95% CI, 1.27–4.64). The BODE index is a strong independent predictor of survival in inoperable NSCLC beyond traditional risk factors. Use of this multidimensional tool may improve risk stratification and prognostication in NSCLC.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>24389436</pmid><doi>10.1097/JTO.0000000000000032</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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subjects Adenocarcinoma - complications
Adenocarcinoma - mortality
Adenocarcinoma - pathology
Adenocarcinoma, Bronchiolo-Alveolar - complications
Adenocarcinoma, Bronchiolo-Alveolar - mortality
Adenocarcinoma, Bronchiolo-Alveolar - pathology
Adult
Aged
Aged, 80 and over
Airway Obstruction - etiology
Airway Obstruction - mortality
Airway Obstruction - physiopathology
Body Mass Index
Carcinoma, Non-Small-Cell Lung - complications
Carcinoma, Non-Small-Cell Lung - mortality
Carcinoma, Non-Small-Cell Lung - pathology
Carcinoma, Squamous Cell - complications
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
Dyspnea - etiology
Dyspnea - mortality
Dyspnea - physiopathology
Exercise
Exercise Tolerance
Female
Follow-Up Studies
Humans
Lung cancer
Lung Neoplasms - complications
Lung Neoplasms - mortality
Lung Neoplasms - pathology
Male
Middle Aged
Neoplasm Staging
Prognosis
Respiratory Function Tests
Survival
Survival Rate
title Prognostic Validation of the Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) Index in Inoperable Non–Small-Cell Lung Cancer
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