title: Prediagnostic body weight and survival in high grade glioma.
abstract: Greater adiposity has been linked to an increased risk and/or poorer survival in a variety of cancers. We examined whether prediagnostic body weight 1-5 years prior to diagnosis is associated with survival in patients with high grade glioma. The analysis was based on a series of patients with high-grade glioma (N = 853) enrolled in a US-based multicenter case-control study. Subjects reported height and weight 1-5 years prior to interview and at age 21. BMI was categorized according to WHO criteria as underweight (BMI <18.5 kg/m(2)), normal weight (BMI 18.5-24.9 kg/m(2)), overweight (BMI 25-29.9 kg/m(2)) and obese (BMI ≥30 kg/m(2)). Proportional hazards regression was used to estimate hazard ratios (HR) and 95 % confidence intervals (CIs) for glioma-related death according to body mass index (BMI, kg/m(2)). Overall survival was reduced among patients underweight (median survival: 12.0 months) or obese (median: 13.6 months) when compared to patients of normal weight (median: 17.5 months) prior to glioma diagnosis (p = 0.004). In a multivariate model controlling for other prognostic factors, an excess mortality was observed in patients reporting obese body weights 1-5 years prior to study interview when compared to patients with a normal BMI (HR = 1.32; 95 % CI 1.04-1.68). Consistent patterns of association with excess body weight were observed in men and women, and all findings were similar regardless of treatment for glioma. A lower than optimal body weight was associated with a nonsignificant excess mortality in multivariate analysis. Premorbid obesity was significantly associated with a poor patient outcome independent of treatment and established prognostic factors. Excess body weight may be an adverse prognostic factor in glioma, a relationship observed across a spectrum of cancer types. The current findings linking prediagnostic body weight with mortality in high-grade glioma warrant further research.
authors.affiliation: Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612-9416, USA.
authors.forename: Erin M
authors.initials: EM
authors.lastname: Siegel
authors.forename: L Burton
authors.initials: LB
authors.lastname: Nabors
authors.forename: Reid C
authors.initials: RC
authors.lastname: Thompson
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Olson
authors.forename: James E
authors.initials: JE
authors.lastname: Browning
authors.forename: Melissa H
authors.initials: MH
authors.lastname: Madden
authors.forename: Gang
authors.initials: G
authors.lastname: Han
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Egan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D001835:Body Weight / Q000502:physiology*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D016022:Case-Control Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D005910:Glioma / Q000175:diagnosis* / Q000401:mortality* / Q000503:physiopathology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D050177:Overweight / Q000150:complications; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013851:Thinness / Q000150:complications