Introduction Unlike most malignancies, higher body mass index (BMI) is associated with a reduced risk of lung cancer and improved prognosis after surgery. However, it remains controversial whether height, one of determinants of BMI, is associated with survival independently of BMI and other confounders. Methods We extracted data on all consecutive patients with resectable non-small cell lung cancer included in Epithor, the French Society of Thoracic and Cardiovascular Surgery database, over a 16-year period. Height was analysed as a continuous variable, and then categorised into four or three categories, according to sex-specific quantiles. Cox proportional hazards regression was used to estimate the association of height with survival, adjusted for age, tobacco consumption, forced expiratory volume in one second (FEV1), WHO performance status (WHO PS), American Society of Anesthesiologists (ASA) score, extent of resection, histological type, stage of disease and centre as a random effect, as well as BMI in a further analysis. Results The study included 61 379 patients. Higher height was significantly associated with better long-term survival after adjustment for other variables (adjusted HR 0.97 per 10 cm higher height, 95% CI 0.95 to 0.99); additional adjustment for BMI resulted in an identical HR. The prognostic impact of height was further confirmed by stratifying by age, ASA class, WHO PS and histological type. When stratifying by BMI class, there was no evidence of a differential association (p=0.93). When stratifying by stage of disease, the prognostic significance of height was maintained for all stages except IIIB-IV. Conclusions Our study shows that height is an independent prognostic factor of resectable lung cancer. Data are available on reasonable request. Data are available after formal request to and acceptance by the French Society of Thoracic and Cardiovascular Surgery.

中文翻译：

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身高对可切除肺癌长期生存的保护作用：肺癌悖论的新特征

简介 与大多数恶性肿瘤不同，较高的体重指数 (BMI) 与降低肺癌风险和改善术后预后相关。然而，身高（BMI 的决定因素之一）是否与生存相关（独立于 BMI 和其他混杂因素）仍存在争议。方法 我们提取了法国胸心血管外科学会数据库 Epithor 中所有连续 16 年期间可切除非小细胞肺癌患者的数据。身高作为连续变量进行分析，然后根据性别分位数分为四类或三类。使用 Cox 比例风险回归来估计身高与生存的关联，并根据年龄、烟草消耗量、一秒用力呼气量 (FEV1)、WHO 体能状态 (WHO PS)、美国麻醉医师协会 (ASA) 评分、程度进行调整切除情况、组织学类型、疾病分期和中心作为随机效应，以及 BMI 进行进一步分析。结果该研究纳入了 61 379 名患者。调整其他变量后，较高的身高与更好的长期生存显着相关（调整后的 HR 每升高 10 厘米 0.97，95% CI 0.95 至 0.99）；对 BMI 进行额外调整会导致相同的 HR。通过按年龄、ASA 分级、WHO PS 和组织学类型分层，进一步证实了身高对预后的影响。当按 BMI 类别分层时，没有证据表明存在差异相关性 (p=0.93)。当按疾病阶段分层时，除了 IIIB-IV 期外，身高的预后意义对于所有阶段均保持不变。结论 我们的研究表明身高是可切除肺癌的独立预后因素。可根据合理要求提供数据。向法国胸心血管外科学会正式请求并接受后即可获得数据。