The effect of body mass index on overall and disease-free survival  in node-positive breast cancer patients treated with docetaxel  and doxorubicin-containing adjuvant chemotherapy:  the experience of the BIG 02-98 trial.
BACKGROUND
Obesity has been shown to be an indicator of poor prognosis for patients with primary breast cancer (BC) regardless of the use of adjuvant systemic therapy.


METHODS
This is a retrospective analysis of 2,887 node-positive BC patients enrolled in the BIG 02-98 adjuvant study, a randomised phase III trial whose primary objective was to evaluate disease-free survival (DFS) by adding docetaxel to doxorubicin-based chemotherapy. In the current analysis, the effect of body mass index (BMI) on DFS and overall survival (OS) was assessed. BMI was obtained before the first cycle of chemotherapy. Obesity was defined as a BMI >or= 30 kg/m2.


RESULTS
In total, 547 (19%) patients were obese at baseline, while 2,340 (81%) patients were non-obese. Estimated 5-year OS was 87.5% for non-obese and 82.9% for obese patients (HR 1.34; P = 0.013). Estimated 5-years DFS was 75.9% for nonobese and 70.0% for obese patients (HR 1.20; P = 0.041). Ina multivariate model, obesity remained an independent prognostic factor for OS and DFS.


CONCLUSIONS
In this study,obesity was associated with poorer outcome in node-positive BC patients. Given the increasing prevalence of obesity worldwide, more research on improving the treatment of obese BC patients is needed.
de Azambuja
Evandro
E
Institut Jules Bordet and Université Libre de Bruxelles (U.L.B), Brussels, Belgium.
McCaskill-Stevens
Worta
W
Francis
Prudence
P
Quinaux
Emmanuel
E
Crown
John P A
JP
Vicente
Malou
M
Giuliani
Rosa
R
Nordenskjöld
Bo
B
Gutiérez
Jorge
J
Andersson
Michael
M
Vila
Mireia Margeli
MM
Jakesz
Raimund
R
Demol
Jan
J
Dewar
Joanna
J
Santoro
Armando
A
Lluch
Ana
A
Olsen
Steven
S
Gelber
Richard D
RD
Di Leo
Angelo
A
Piccart-Gebhart
Martine
M
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D017024:Chemotherapy, Adjuvant / Q000379:methods*; D018572:Disease-Free Survival; D000077143:Docetaxel; D004317:Doxorubicin / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009765:Obesity / Q000150:complications*; D011379:Prognosis; D012189:Retrospective Studies; D043823:Taxoids / Q000627:therapeutic use*; D016896:Treatment Outcome
D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D004317:Doxorubicin