title: 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.
abstract: 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.
authors.affiliation: Institut Jules Bordet and Université Libre de Bruxelles (U.L.B), Brussels, Belgium.
authors.forename: Evandro
authors.initials: E
authors.lastname: de Azambuja
authors.forename: Worta
authors.initials: W
authors.lastname: McCaskill-Stevens
authors.forename: Prudence
authors.initials: P
authors.lastname: Francis
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Quinaux
authors.forename: John P A
authors.initials: JP
authors.lastname: Crown
authors.forename: Malou
authors.initials: M
authors.lastname: Vicente
authors.forename: Rosa
authors.initials: R
authors.lastname: Giuliani
authors.forename: Bo
authors.initials: B
authors.lastname: Nordenskjöld
authors.forename: Jorge
authors.initials: J
authors.lastname: Gutiérez
authors.forename: Michael
authors.initials: M
authors.lastname: Andersson
authors.forename: Mireia Margeli
authors.initials: MM
authors.lastname: Vila
authors.forename: Raimund
authors.initials: R
authors.lastname: Jakesz
authors.forename: Jan
authors.initials: J
authors.lastname: Demol
authors.forename: Joanna
authors.initials: J
authors.lastname: Dewar
authors.forename: Armando
authors.initials: A
authors.lastname: Santoro
authors.forename: Ana
authors.initials: A
authors.lastname: Lluch
authors.forename: Steven
authors.initials: S
authors.lastname: Olsen
authors.forename: Richard D
authors.initials: RD
authors.lastname: Gelber
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Leo
authors.forename: Martine
authors.initials: M
authors.lastname: Piccart-Gebhart
mesh_terms: 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
chemical_list: D000970:Antineoplastic Agents; D043823:Taxoids; D000077143:Docetaxel; D004317:Doxorubicin