title: Overweight and obesity predict better overall survival rates in cancer patients with distant metastases.
abstract: Recent studies conducted in patients with chronic diseases have reported an inverse association between body mass index (BMI) and mortality. However, the question as to whether BMI may predict prognosis in patients with metastatic cancer remains open. We therefore designed the current retrospective study to investigate the potential association between BMI and overall survival (OS) in patients with distant metastases (DM) and a favorable performance status. Between 2000 and 2012, a total of 4010 cancer patients with DM who required radiotherapy (RT) and had their BMI measured at the initiation of RT were identified. The relation between BMI and OS was examined by univariate and multivariable analysis. The median OS time was 3.23 months (range: 0.1-122.17) for underweight patients, 6.08 months (range: 0.03-149.46) for normal-weight patients, 7.99 months (range: 0.07-158.01) for overweight patients, and 12.49 months (range, 0.2-164.1) for obese patients (log-rank: P < 0.001). Compared with normal-weight patients, both obese (HR = 0.676; 95% P < 0.001) and overweight individuals (HR = 0.84; P < 0.001) had a reduced risk of all-cause mortality in multivariable analysis. Conversely, underweight patients had a significantly higher risk of death from all causes (HR = 1.41; P < 0.001). Overweight and obesity are independent predictors of better OS in metastatic patients with a good performance status. Increased BMI may play a role to identify metastatic patients with superior survival outcome and exhibit a potential to encourage aggressive management in those patients even with metastases.
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan.|School of Traditional Chinese Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Ngan Ming
authors.initials: NM
authors.lastname: Tsang
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan.
authors.forename: Ping Ching
authors.initials: PC
authors.lastname: Pai
authors.affiliation: Department of Neurosurgery, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan.
authors.forename: Chi Cheng
authors.initials: CC
authors.lastname: Chuang
authors.affiliation: School of Medicine, Chang Gung University, Taoyuan, Taiwan.
authors.forename: Wen Ching
authors.initials: WC
authors.lastname: Chuang
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan.
authors.forename: Chen Kan
authors.initials: CK
authors.lastname: Tseng
authors.affiliation: Departments of Otolaryngology- Head Neck Surgery, Chang Gung Memorial Hospital and Chang Gung University at Lin-Kou, Taoyuan, Taiwan.
authors.forename: Kai Ping
authors.initials: KP
authors.lastname: Chang
authors.affiliation: Departments of Nuclear Medicine and Molecular Imaging Center, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan.
authors.forename: Tzu Chen
authors.initials: TC
authors.lastname: Yen
authors.affiliation: Department of Internal Medicine, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan.
authors.forename: Jen Der
authors.initials: JD
authors.lastname: Lin
authors.affiliation: Department of Radiation Oncology, Chang Gung Memorial Hospital and University at Lin-Kou, Taoyuan, Taiwan.
authors.forename: Joseph Tung Chieh
authors.initials: JT
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015992:Body Mass Index; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D009765:Obesity / Q000150:complications*; D050177:Overweight / Q000150:complications*; D011159:Population Surveillance; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
keywords: BMI; body mass index; metastatic cancer; obesity; overall survival.
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