Body mass index and prognosis of metastatic breast cancer patients receiving first-line chemotherapy.
BACKGROUND
The effect of body mass index (BMI) on the prognosis of metastatic breast cancer (MBC) has not been explored so far.


METHODS
The relationship between BMI (kg/m(2)) and progression-free survival (PFS) or overall survival (OS) was assessed in 489 patients with MBC enrolled in three clinical trials of first-line chemotherapy. World Health Organization BMI categories were used: normal, 18.5-24.9 kg/m(2); overweight, 25-29.9 kg/m(2); and obese, 30+ kg/m(2). Univariate PFS and OS curves were estimated; multivariate Cox analysis was conducted adjusting for age, menopausal status, performance status (PS), hormonal status and site, and number of metastases.


RESULTS
Overall, 39.9% of the patients were normal or underweight, 37.8% were overweight, and 22.3% were obese. Median age was 57 years (range 25-73); median PS was 0. Median PFS was 10.9 months [interquartile range (IQR) 5.5 to 19.9] in normal weight women, 13.0 months (IQR 7.8 to 23.7) in overweight, and 12.2 (IQR 7.1 to 23.0) in obese women, P = 0.17. Median OS was 32.0 months [95% confidence interval (CI), 14.5-88.3] versus 33.2 months (95% CI, 19.4-81.1) and 30.7 (95% CI, 17.6-50.8), respectively. In multivariate analyses, no statistically significant association between BMI category and PFS or OS was observed.


CONCLUSIONS
In this study, BMI was not associated with the outcome of patients with MBC treated with first-line chemotherapy.


CONCLUSIONS
In the absence of any evidence in support of a prognostic role of obesity in patients with MBC treated with chemotherapy, dietary restrictions, medical interventions aimed at reducing BMI/insulin resistance, or specific anticancer treatment strategies do not seem to be appropriate.
Authors' Affiliations: Divisions of Medical Oncology and Internal Medicine; Office of the Scientific Director, Galliera Hospital; IRCCS San Martino-IST, Genoa; IRCCS-IRST, Romagna Cancer Institute, Meldola (FC); and University of Padova, Padova, Italy.
Alessandra
A
Gennari
Oriana
O
Nanni
Matteo
M
Puntoni
Andrea
A
DeCensi
Emanuela
E
Scarpi
PierFranco
P
Conte
Giancarlo
G
Antonucci
Dino
D
Amadori
Paolo
P
Bruzzi
D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015992:Body Mass Index; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology*; D002986:Clinical Trials as Topic; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009765:Obesity / Q000473:pathology; D016016:Proportional Hazards Models