Jiang, Mei, Fares, Aline F, Shepshelovich, Daniel, Yang, Ping, Christiani, David, Zhang, Jie, Shiraishi, Kouya, Ryan, Brid M, Chen, Chu, Schwartz, Ann G et al (show 28 more authors)
(2021)
The relationship between body-mass index and overall survival in non-small cell lung cancer by sex, smoking status, and race: A pooled analysis of 20,937 International lung Cancer consortium (ILCCO) patients.
Lung Cancer, 152.
pp. 58-65.
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Abstract
<h4>Introduction</h4>The relationship between Body-Mass-Index (BMI) and lung cancer prognosis is heterogeneous. We evaluated the impact of sex, smoking and race on the relationship between BMI and overall survival (OS) in non-small-cell-lung-cancer (NSCLC).<h4>Methods</h4>Data from 16 individual ILCCO studies were pooled to assess interactions between BMI and the following factors on OS: self-reported race, smoking status and sex, using Cox models (adjusted hazard ratios; aHR) with interaction terms and adjusted penalized smoothing spline plots in stratified analyses.<h4>Results</h4>Among 20,937 NSCLC patients with BMI values, females = 47 %; never-smokers = 14 %; White-patients = 76 %. BMI showed differential survival according to race whereby compared to normal-BMI patients, being underweight was associated with poor survival among white patients (OS, aHR = 1.66) but not among black patients (aHR = 1.06; p<sub>interaction</sub> = 0.02). Comparing overweight/obese to normal weight patients, Black NSCLC patients who were overweight/obese also had relatively better OS (p<sub>interaction</sub> = 0.06) when compared to White-patients. BMI was least associated with survival in Asian-patients and never-smokers. The outcomes of female ever-smokers at the extremes of BMI were associated with worse outcomes in both the underweight (p<sub>interaction</sub><0.001) and obese categories (p<sub>interaction</sub> = 0.004) relative to the normal-BMI category, when compared to male ever-smokers.<h4>Conclusion</h4>Underweight and obese female ever-smokers were associated with worse outcomes in White-patients. These BMI associations were not observed in Asian-patients and never-smokers. Black-patients had more favorable outcomes in the extremes of BMI when compared to White-patients. Body composition in Black-patients, and NSCLC subtypes more commonly seen in Asian-patients and never-smokers, may account for differences in these BMI-OS relationships.
Item Type: | Article |
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Uncontrolled Keywords: | Body mass index, Obesity, Lung cancer, Interaction |
Divisions: | Faculty of Health and Life Sciences Faculty of Health and Life Sciences > Institute of Systems, Molecular and Integrative Biology |
Depositing User: | Symplectic Admin |
Date Deposited: | 07 Apr 2021 09:59 |
Last Modified: | 18 Jan 2023 23:02 |
DOI: | 10.1016/j.lungcan.2020.11.029 |
Related URLs: | |
URI: | https://livrepository.liverpool.ac.uk/id/eprint/3114833 |