Body Mass Index (BMI), BMI Change, and Overall Survival in Patients With SCLC and NSCLC: A Pooled Analysis of the International Lung Cancer Consortium
The relationships between morbid obesity, changes in body mass index (BMI) before cancer diagnosis, and lung cancer outcomes by histology (SCLC and NSCLC) have not been well studied. Individual level data analysis was performed on 25,430 patients with NSCLC and 2787 patients with SCLC from 16 studie...
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| Veröffentlicht in: | Journal of thoracic oncology 2019-09, Vol.14 (9), p.1594-1607 |
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| creator | Shepshelovich, Daniel Xu, Wei Lu, Lin Fares, Aline Yang, Ping Christiani, David Zhang, Jie Shiraishi, Kouya Ryan, Brid M. Chen, Chu Schwartz, Ann G. Tardon, Adonina Wu, Xifeng Schabath, Matthew B. Teare, M. Dawn Le Marchand, Loic Zhang, Zuo-Feng Field, John K. Brenner, Hermann Diao, Nancy Xie, Juntao Kohno, Takashi Harris, Curtis C. Wenzlaff, Angela S. Fernandez-Tardon, Guillermo Ye, Yuanqing Taylor, Fiona Wilkens, Lynne R. Davies, Michael Liu, Yi Barnett, Matt J. Goodman, Gary E. Morgenstern, Hal Holleczek, Bernd Brown, M. Catherine Liu, Geoffrey Hung, Rayjean J. |
| description | The relationships between morbid obesity, changes in body mass index (BMI) before cancer diagnosis, and lung cancer outcomes by histology (SCLC and NSCLC) have not been well studied.
Individual level data analysis was performed on 25,430 patients with NSCLC and 2787 patients with SCLC from 16 studies of the International Lung Cancer Consortium evaluating the association between various BMI variables and lung cancer overall survival, reported as adjusted hazard ratios (aHRs) from Cox proportional hazards models and adjusted penalized smoothing spline plots.
Overall survival of NSCLC had putative U-shaped hazard ratio relationships with BMI based on spline plots: being underweight (BMI < 18.5 kg/m2; aHR = 1.56; 95% confidence interval [CI]:1.43–1.70) or morbidly overweight (BMI > 40 kg/m2; aHR = 1.09; 95% CI: 0.95–1.26) at the time of diagnosis was associated with worse stage-specific prognosis, whereas being overweight (25 kg/m2 ≤ BMI < 30 kg/m2; aHR = 0.89; 95% CI: 0.85–0.95) or obese (30 kg/m2 ≤ BMI ≤ 40 kg/m2; aHR = 0.86; 95% CI: 0.82–0.91) was associated with improved survival. Although not significant, a similar pattern was seen with SCLC. Compared with an increased or stable BMI from the period between young adulthood until date of diagnosis, a decreased BMI was associated with worse outcomes in NSCLC (aHR = 1.24; 95% CI: 1.2–1.3) and SCLC patients (aHR=1.26 (95% CI: 1.0–1.6). Decreased BMI was consistently associated with worse outcome, across clinicodemographic subsets.
Both being underweight or morbidly obese at time of diagnosis is associated with lower stage-specific survival in independent assessments of NSCLC and SCLC patients. In addition, a decrease in BMI at lung cancer diagnosis relative to early adulthood is a consistent marker of poor survival. |
| doi_str_mv | 10.1016/j.jtho.2019.05.031 |
| format | Article |
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Individual level data analysis was performed on 25,430 patients with NSCLC and 2787 patients with SCLC from 16 studies of the International Lung Cancer Consortium evaluating the association between various BMI variables and lung cancer overall survival, reported as adjusted hazard ratios (aHRs) from Cox proportional hazards models and adjusted penalized smoothing spline plots.
Overall survival of NSCLC had putative U-shaped hazard ratio relationships with BMI based on spline plots: being underweight (BMI < 18.5 kg/m2; aHR = 1.56; 95% confidence interval [CI]:1.43–1.70) or morbidly overweight (BMI > 40 kg/m2; aHR = 1.09; 95% CI: 0.95–1.26) at the time of diagnosis was associated with worse stage-specific prognosis, whereas being overweight (25 kg/m2 ≤ BMI < 30 kg/m2; aHR = 0.89; 95% CI: 0.85–0.95) or obese (30 kg/m2 ≤ BMI ≤ 40 kg/m2; aHR = 0.86; 95% CI: 0.82–0.91) was associated with improved survival. Although not significant, a similar pattern was seen with SCLC. Compared with an increased or stable BMI from the period between young adulthood until date of diagnosis, a decreased BMI was associated with worse outcomes in NSCLC (aHR = 1.24; 95% CI: 1.2–1.3) and SCLC patients (aHR=1.26 (95% CI: 1.0–1.6). Decreased BMI was consistently associated with worse outcome, across clinicodemographic subsets.
Both being underweight or morbidly obese at time of diagnosis is associated with lower stage-specific survival in independent assessments of NSCLC and SCLC patients. In addition, a decrease in BMI at lung cancer diagnosis relative to early adulthood is a consistent marker of poor survival.</description><identifier>ISSN: 1556-0864</identifier><identifier>ISSN: 1556-1380</identifier><identifier>EISSN: 1556-1380</identifier><identifier>DOI: 10.1016/j.jtho.2019.05.031</identifier><identifier>PMID: 31163278</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Body Mass Index ; Carcinoma, Non-Small-Cell Lung - mortality ; Carcinoma, Non-Small-Cell Lung - physiopathology ; Female ; Humans ; Lung cancer ; Lung Neoplasms - mortality ; Lung Neoplasms - physiopathology ; Male ; Middle Aged ; Risk Factors ; Small Cell Lung Carcinoma - mortality ; Small Cell Lung Carcinoma - physiopathology ; Survival ; Survival Analysis ; Young Adult</subject><ispartof>Journal of thoracic oncology, 2019-09, Vol.14 (9), p.1594-1607</ispartof><rights>2019 International Association for the Study of Lung Cancer</rights><rights>Copyright © 2019 by the International Association for the Study of Lung Cancer</rights><rights>Copyright © 2019 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c5003-3809da5540b5226c8d6699c85d244f90e46d0a86c16ef5738071437844f009a13</citedby><cites>FETCH-LOGICAL-c5003-3809da5540b5226c8d6699c85d244f90e46d0a86c16ef5738071437844f009a13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31163278$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shepshelovich, Daniel</creatorcontrib><creatorcontrib>Xu, Wei</creatorcontrib><creatorcontrib>Lu, Lin</creatorcontrib><creatorcontrib>Fares, Aline</creatorcontrib><creatorcontrib>Yang, Ping</creatorcontrib><creatorcontrib>Christiani, David</creatorcontrib><creatorcontrib>Zhang, Jie</creatorcontrib><creatorcontrib>Shiraishi, Kouya</creatorcontrib><creatorcontrib>Ryan, Brid M.</creatorcontrib><creatorcontrib>Chen, Chu</creatorcontrib><creatorcontrib>Schwartz, Ann G.</creatorcontrib><creatorcontrib>Tardon, Adonina</creatorcontrib><creatorcontrib>Wu, Xifeng</creatorcontrib><creatorcontrib>Schabath, Matthew B.</creatorcontrib><creatorcontrib>Teare, M. Dawn</creatorcontrib><creatorcontrib>Le Marchand, Loic</creatorcontrib><creatorcontrib>Zhang, Zuo-Feng</creatorcontrib><creatorcontrib>Field, John K.</creatorcontrib><creatorcontrib>Brenner, Hermann</creatorcontrib><creatorcontrib>Diao, Nancy</creatorcontrib><creatorcontrib>Xie, Juntao</creatorcontrib><creatorcontrib>Kohno, Takashi</creatorcontrib><creatorcontrib>Harris, Curtis C.</creatorcontrib><creatorcontrib>Wenzlaff, Angela S.</creatorcontrib><creatorcontrib>Fernandez-Tardon, Guillermo</creatorcontrib><creatorcontrib>Ye, Yuanqing</creatorcontrib><creatorcontrib>Taylor, Fiona</creatorcontrib><creatorcontrib>Wilkens, Lynne R.</creatorcontrib><creatorcontrib>Davies, Michael</creatorcontrib><creatorcontrib>Liu, Yi</creatorcontrib><creatorcontrib>Barnett, Matt J.</creatorcontrib><creatorcontrib>Goodman, Gary E.</creatorcontrib><creatorcontrib>Morgenstern, Hal</creatorcontrib><creatorcontrib>Holleczek, Bernd</creatorcontrib><creatorcontrib>Brown, M. Catherine</creatorcontrib><creatorcontrib>Liu, Geoffrey</creatorcontrib><creatorcontrib>Hung, Rayjean J.</creatorcontrib><title>Body Mass Index (BMI), BMI Change, and Overall Survival in Patients With SCLC and NSCLC: A Pooled Analysis of the International Lung Cancer Consortium</title><title>Journal of thoracic oncology</title><addtitle>J Thorac Oncol</addtitle><description>The relationships between morbid obesity, changes in body mass index (BMI) before cancer diagnosis, and lung cancer outcomes by histology (SCLC and NSCLC) have not been well studied.
Individual level data analysis was performed on 25,430 patients with NSCLC and 2787 patients with SCLC from 16 studies of the International Lung Cancer Consortium evaluating the association between various BMI variables and lung cancer overall survival, reported as adjusted hazard ratios (aHRs) from Cox proportional hazards models and adjusted penalized smoothing spline plots.
Overall survival of NSCLC had putative U-shaped hazard ratio relationships with BMI based on spline plots: being underweight (BMI < 18.5 kg/m2; aHR = 1.56; 95% confidence interval [CI]:1.43–1.70) or morbidly overweight (BMI > 40 kg/m2; aHR = 1.09; 95% CI: 0.95–1.26) at the time of diagnosis was associated with worse stage-specific prognosis, whereas being overweight (25 kg/m2 ≤ BMI < 30 kg/m2; aHR = 0.89; 95% CI: 0.85–0.95) or obese (30 kg/m2 ≤ BMI ≤ 40 kg/m2; aHR = 0.86; 95% CI: 0.82–0.91) was associated with improved survival. Although not significant, a similar pattern was seen with SCLC. Compared with an increased or stable BMI from the period between young adulthood until date of diagnosis, a decreased BMI was associated with worse outcomes in NSCLC (aHR = 1.24; 95% CI: 1.2–1.3) and SCLC patients (aHR=1.26 (95% CI: 1.0–1.6). Decreased BMI was consistently associated with worse outcome, across clinicodemographic subsets.
Both being underweight or morbidly obese at time of diagnosis is associated with lower stage-specific survival in independent assessments of NSCLC and SCLC patients. In addition, a decrease in BMI at lung cancer diagnosis relative to early adulthood is a consistent marker of poor survival.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Body Mass Index</subject><subject>Carcinoma, Non-Small-Cell Lung - mortality</subject><subject>Carcinoma, Non-Small-Cell Lung - physiopathology</subject><subject>Female</subject><subject>Humans</subject><subject>Lung cancer</subject><subject>Lung Neoplasms - mortality</subject><subject>Lung Neoplasms - physiopathology</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Risk Factors</subject><subject>Small Cell Lung Carcinoma - mortality</subject><subject>Small Cell Lung Carcinoma - physiopathology</subject><subject>Survival</subject><subject>Survival Analysis</subject><subject>Young Adult</subject><issn>1556-0864</issn><issn>1556-1380</issn><issn>1556-1380</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9UctuEzEUHSEQLYUfYIG8LFInXI8fM4MQUjriESmllQpiabm2k3Fw7GLPpORH-F4cEirYsPD1le455z5OUTzHMMGA-avVZDX0YVIBbifAJkDwg-IYM8ZLTBp4eMih4fSoeJLSCoAyoM3j4ohgzElVN8fFz_Ogt-hCpoRmXpsf6PT8YvbyDOWIul76pTlD0mt0uTFROoeux7ixG-mQ9ehKDtb4IaGvdujRdTfvfkM_7bLXaIquQnBGo6mXbptsQmGBht7kPoOJPnNDLqD56Jeok16ZiLrgU4iDHddPi0cL6ZJ5dvhPii_v333uPpbzyw-zbjovFQMgZV6z1ZIxCjesqrhqNOdtqxqmK0oXLRjKNciGK8zNgtUZXmNK6iYXAVqJyUnxdq97O96sjVZ5nbymuI12LeNWBGnFvxVve7EMG8FrQlvCssDpQSCG76NJg1jbpIxz0pswJlFVDGNgHOoMrfZQFUNK0Szu22AQO0PFSuwMFTtDBTCRDc2kF38PeE_542AG0D3gLrh81_TNjXcmit5IN_QCcEVJ09JypwktAJT5YZJpb_Y0k6-7sZmRVDZTGW2jUYPQwf5vrF_ox79w</recordid><startdate>201909</startdate><enddate>201909</enddate><creator>Shepshelovich, Daniel</creator><creator>Xu, Wei</creator><creator>Lu, Lin</creator><creator>Fares, Aline</creator><creator>Yang, Ping</creator><creator>Christiani, David</creator><creator>Zhang, Jie</creator><creator>Shiraishi, Kouya</creator><creator>Ryan, Brid M.</creator><creator>Chen, Chu</creator><creator>Schwartz, Ann G.</creator><creator>Tardon, Adonina</creator><creator>Wu, Xifeng</creator><creator>Schabath, Matthew B.</creator><creator>Teare, M. 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Dawn ; Le Marchand, Loic ; Zhang, Zuo-Feng ; Field, John K. ; Brenner, Hermann ; Diao, Nancy ; Xie, Juntao ; Kohno, Takashi ; Harris, Curtis C. ; Wenzlaff, Angela S. ; Fernandez-Tardon, Guillermo ; Ye, Yuanqing ; Taylor, Fiona ; Wilkens, Lynne R. ; Davies, Michael ; Liu, Yi ; Barnett, Matt J. ; Goodman, Gary E. ; Morgenstern, Hal ; Holleczek, Bernd ; Brown, M. 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Dawn</au><au>Le Marchand, Loic</au><au>Zhang, Zuo-Feng</au><au>Field, John K.</au><au>Brenner, Hermann</au><au>Diao, Nancy</au><au>Xie, Juntao</au><au>Kohno, Takashi</au><au>Harris, Curtis C.</au><au>Wenzlaff, Angela S.</au><au>Fernandez-Tardon, Guillermo</au><au>Ye, Yuanqing</au><au>Taylor, Fiona</au><au>Wilkens, Lynne R.</au><au>Davies, Michael</au><au>Liu, Yi</au><au>Barnett, Matt J.</au><au>Goodman, Gary E.</au><au>Morgenstern, Hal</au><au>Holleczek, Bernd</au><au>Brown, M. Catherine</au><au>Liu, Geoffrey</au><au>Hung, Rayjean J.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Body Mass Index (BMI), BMI Change, and Overall Survival in Patients With SCLC and NSCLC: A Pooled Analysis of the International Lung Cancer Consortium</atitle><jtitle>Journal of thoracic oncology</jtitle><addtitle>J Thorac Oncol</addtitle><date>2019-09</date><risdate>2019</risdate><volume>14</volume><issue>9</issue><spage>1594</spage><epage>1607</epage><pages>1594-1607</pages><issn>1556-0864</issn><issn>1556-1380</issn><eissn>1556-1380</eissn><abstract>The relationships between morbid obesity, changes in body mass index (BMI) before cancer diagnosis, and lung cancer outcomes by histology (SCLC and NSCLC) have not been well studied.
Individual level data analysis was performed on 25,430 patients with NSCLC and 2787 patients with SCLC from 16 studies of the International Lung Cancer Consortium evaluating the association between various BMI variables and lung cancer overall survival, reported as adjusted hazard ratios (aHRs) from Cox proportional hazards models and adjusted penalized smoothing spline plots.
Overall survival of NSCLC had putative U-shaped hazard ratio relationships with BMI based on spline plots: being underweight (BMI < 18.5 kg/m2; aHR = 1.56; 95% confidence interval [CI]:1.43–1.70) or morbidly overweight (BMI > 40 kg/m2; aHR = 1.09; 95% CI: 0.95–1.26) at the time of diagnosis was associated with worse stage-specific prognosis, whereas being overweight (25 kg/m2 ≤ BMI < 30 kg/m2; aHR = 0.89; 95% CI: 0.85–0.95) or obese (30 kg/m2 ≤ BMI ≤ 40 kg/m2; aHR = 0.86; 95% CI: 0.82–0.91) was associated with improved survival. Although not significant, a similar pattern was seen with SCLC. Compared with an increased or stable BMI from the period between young adulthood until date of diagnosis, a decreased BMI was associated with worse outcomes in NSCLC (aHR = 1.24; 95% CI: 1.2–1.3) and SCLC patients (aHR=1.26 (95% CI: 1.0–1.6). Decreased BMI was consistently associated with worse outcome, across clinicodemographic subsets.
Both being underweight or morbidly obese at time of diagnosis is associated with lower stage-specific survival in independent assessments of NSCLC and SCLC patients. In addition, a decrease in BMI at lung cancer diagnosis relative to early adulthood is a consistent marker of poor survival.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>31163278</pmid><doi>10.1016/j.jtho.2019.05.031</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
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| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6734935 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Adolescent Adult Aged Aged, 80 and over Body Mass Index Carcinoma, Non-Small-Cell Lung - mortality Carcinoma, Non-Small-Cell Lung - physiopathology Female Humans Lung cancer Lung Neoplasms - mortality Lung Neoplasms - physiopathology Male Middle Aged Risk Factors Small Cell Lung Carcinoma - mortality Small Cell Lung Carcinoma - physiopathology Survival Survival Analysis Young Adult |
| title | Body Mass Index (BMI), BMI Change, and Overall Survival in Patients With SCLC and NSCLC: A Pooled Analysis of the International Lung Cancer Consortium |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-02T09%3A37%3A14IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Body%20Mass%20Index%20(BMI),%20BMI%20Change,%20and%20Overall%20Survival%20in%20Patients%20With%20SCLC%20and%20NSCLC:%20A%20Pooled%20Analysis%20of%20the%20International%20Lung%20Cancer%20Consortium&rft.jtitle=Journal%20of%20thoracic%20oncology&rft.au=Shepshelovich,%20Daniel&rft.date=2019-09&rft.volume=14&rft.issue=9&rft.spage=1594&rft.epage=1607&rft.pages=1594-1607&rft.issn=1556-0864&rft.eissn=1556-1380&rft_id=info:doi/10.1016/j.jtho.2019.05.031&rft_dat=%3Cproquest_pubme%3E2251105607%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2251105607&rft_id=info:pmid/31163278&rft_els_id=S1556086419304162&rfr_iscdi=true |