Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes: a pooled analysis

Obesity is an unfavorable prognostic factor in breast cancer (BC) patients regardless of menopausal status and treatment received. However, the association between obesity and survival outcome by pathological subtype requires further clarification. We performed a retrospective analysis including 5,6...

Full description

Saved in:
Bibliographic Details
Published in:Breast cancer research : BCR 2013-11, Vol.15 (6), p.R105-R105, Article R105
Main Authors: Pajares, Bella, Pollán, Marina, Martín, Miguel, Mackey, John R, Lluch, Ana, Gavila, Joaquín, Vogel, Charles, Ruiz-Borrego, Manuel, Calvo, Lourdes, Pienkowski, Tadeusz, Rodríguez-Lescure, Álvaro, Seguí, Miguel Angel, Tredan, Olivier, Antón, Antonio, Ramos, Manuel, Cámara, María del Carmen, Rodríguez-Martín, César, Carrasco, Eva, Alba, Emilio
Format: Article
Language:English
Subjects:
Adult
Aged
Anthracyclines
Anthracyclines - therapeutic use
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Body Mass Index
Breast cancer
Breast Neoplasms - drug therapy
Breast Neoplasms - mortality
Breast Neoplasms - pathology
Breast Neoplasms - surgery
Cancer
Chemotherapy
Complications and side effects
Disease-Free Survival
Diseases
Dosage and administration
Dose-Response Relationship, Drug
Drug therapy
Female
Humans
Menopause
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local - drug therapy
Obesity
Obesity - etiology
Prognosis
Receptor, ErbB-2 - metabolism
Relapse
Taxoids - therapeutic use
Treatment Outcome
Young Adult
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Obesity is an unfavorable prognostic factor in breast cancer (BC) patients regardless of menopausal status and treatment received. However, the association between obesity and survival outcome by pathological subtype requires further clarification. We performed a retrospective analysis including 5,683 operable BC patients enrolled in four randomized clinical trials (GEICAM/9906, GEICAM/9805, GEICAM/2003-02, and BCIRG 001) evaluating anthracyclines and taxanes as adjuvant treatments. Our primary aim was to assess the prognostic effect of body mass index (BMI) on disease recurrence, breast cancer mortality (BCM), and overall mortality (OM). A secondary aim was to detect differences of such prognostic effects by subtype. Multivariate survival analyses adjusting for age, tumor size, nodal status, menopausal status, surgery type, histological grade, hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, chemotherapy regimen, and under-treatment showed that obese patients (BMI 30.0 to 34.9) had similar prognoses to that of patients with a BMI < 25 (reference group) in terms of recurrence (Hazard Ratio [HR] = 1.08, 95% Confidence Interval [CI] = 0.90 to 1.30), BCM (HR = 1.02, 0.81 to 1.29), and OM (HR = 0.97, 0.78 to 1.19). Patients with severe obesity (BMI ≥ 35) had a significantly increased risk of recurrence (HR = 1.26, 1.00 to 1.59, P = 0.048), BCM (HR = 1.32, 1.00 to 1.74, P = 0.050), and OM (HR = 1.35, 1.06 to 1.71, P = 0.016) compared to our reference group. The prognostic effect of severe obesity did not vary by subtype. Severely obese patients treated with anthracyclines and taxanes present a worse prognosis regarding recurrence, BCM, and OM than patients with BMI < 25. The magnitude of the harmful effect of BMI on survival-related outcomes was similar across subtypes.
ISSN:1465-542X
1465-5411
1465-542X
DOI:10.1186/bcr3572