Clinical Colorectal Cancer ( IF 3.4 ) Pub Date : 2023-02-05 , DOI: 10.1016/j.clcc.2023.01.004 Debora Basile 1 , Gerardo Rosati 2 , Francesca Bergamo 3 , Silvio Ken Garattini 4 , Maria Banzi 5 , Maria Zampino 6 , Silvia Bozzarelli 7 , Paolo Marchetti 8 , Fabio Galli 9 , Francesca Galli 9 , Raffaella Longarini 10 , Alberto Zaniboni 11 , Daris Ferrari 12 , Sabino De Placido 13 , Luca Giovanni Frassineti 14 , Mario Nicolini 15 , Saverio Cinieri 16 , Michele Priscindiaro 17 , Pina Ziranu 18 , Riccardo Caccialanza 19 , Alessandro Pastorino 20 , Stefania Mosconi 21 , Giuseppe Aprile 1
Background
High body mass index (BMI) plays a key role in the development of colon cancer (CC). Our post-hoc analysis from the TOSCA trial analyzed the association between BMI and survival outcomes in terms of relapse-free survival (RFS) and overall survival (OS) in stage II/III CC patients.
Patients and methods
Patients enrolled in the TOSCA trial between 2007-2013 with BMI data entered the study. The prognostic impact of BMI on survival outcomes was investigated through uni- and multivariable Cox regression analyses.
Results
Overall, 1455 patients with stage II/III CC patients were included. The median follow-up was of 61.5 months; 16.1% of patients relapsed, 11.2% died and 19.5% patients relapsed or died. No impact of BMI on RFS was detected at univariate or multivariable analyses. By univariate analysis for OS, a significantly impact of a BMI > 30 kg/m2 was reported (HR [>30 vs <25] 1.57, 95% CI 1.00-2.47, p = 0.049; HR [>30 vs <30] 1.55, 95% CI 1.01-2.37, p = 0.045). Multivariable analyses did not confirm this data. In the subgroup of stage III patients, a negative survival impact of BMI was found in univariate and multivariable models both for RFS and for OS.
Conclusions
In our study, obesity with BMI > 30 kg/m2 was an independent prognostic factor for RFS and OS in CC patients treated with adjuvant chemotherapy, regardless of its duration (3 or 6 months). However, the prognostic impact of adiposity and body composition measurement should be considered to better classify patients with high visceral fat and refine their risk assessment.
中文翻译：
体重指数对 II/III 期结肠癌的预后价值：TOSCA 试验的事后分析
背景
高体重指数（BMI）在结肠癌（CC）的发展中起着关键作用。我们对 TOSCA 试验的事后分析分析了 BMI 与 II/III 期 CC 患者无复发生存 (RFS) 和总生存 (OS) 方面的生存结果之间的关联。
患者和方法
2007 年至 2013 年间参加 TOSCA 试验并具有 BMI 数据的患者进入了研究。通过单变量和多变量 Cox 回归分析研究了 BMI 对生存结果的预后影响。
结果
总体而言，纳入了 1455 名 II/III 期 CC 患者。中位随访时间为 61.5 个月；16.1%的患者复发，11.2%的患者死亡，19.5%的患者复发或死亡。单变量或多变量分析未检测到 BMI 对 RFS 的影响。通过对 OS 的单变量分析，报告了 BMI > 30 kg/m 2的显着影响（HR [>30 vs <25] 1.57，95% CI 1.00-2.47，p = 0.049；HR [>30 vs <30] 1.55，95% CI 1.01-2.37，p = 0.045）。多变量分析并未证实该数据。在 III 期患者亚组中，单变量和多变量模型中发现 BMI 对 RFS 和 OS 的生存都有负面影响。
结论
在我们的研究中，BMI > 30 kg/m 2的肥胖是接受辅助化疗的 CC 患者 RFS 和 OS 的独立预后因素，无论其持续时间如何（3 或 6 个月）。然而，应考虑肥胖和身体成分测量的预后影响，以更好地对高内脏脂肪患者进行分类并完善其风险评估。
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