Obesity and weight loss at presentation of lung cancer are associated with opposite effects on survival.

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Tytuł:: Obesity and weight loss at presentation of lung cancer are associated with opposite effects on survival.
Autorzy:: Yang R; DeWitt Daughtry Family Department of Surgery, Division of Surgical Oncology, Sylvester Comprehensive Cancer Center, University of Miami Miller School of Medicine, Miami, Florida 33136, USA.
Cheung MC
Pedroso FE
Byrne MM
Koniaris LG
Zimmers TA
Źródło:: The Journal of surgical research [J Surg Res] 2011 Sep; Vol. 170 (1), pp. e75-83. Date of Electronic Publication: 2011 May 23.
Typ publikacji:: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.
Język:: English
Imprint Name(s):: Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
MeSH Terms:: Lung Neoplasms/*mortality
Obesity/*physiopathology
Weight Loss/*physiology
Adult ; Aged ; Comorbidity ; Female ; Humans ; Lung Neoplasms/pathology ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Staging
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Grant Information:: R01 CA122596-02 United States CA NCI NIH HHS; R01 GM092758 United States GM NIGMS NIH HHS; R01 GM092758-02 United States GM NIGMS NIH HHS; R01 CA122596 United States CA NCI NIH HHS; R01 GM092758-01A1S1 United States GM NIGMS NIH HHS; R01 GM092758-03 United States GM NIGMS NIH HHS; R01 CA122596-01A2 United States CA NCI NIH HHS; R01 GM092758-01A1 United States GM NIGMS NIH HHS; R01 CA122596-02W1 United States CA NCI NIH HHS; R01 CA122596-03 United States CA NCI NIH HHS
Entry Date(s):: Date Created: 20110628 Date Completed: 20111013 Latest Revision: 20211020
Update Code:: 20240104
PubMed Central ID:: PMC3154461
DOI:: 10.1016/j.jss.2011.04.061
PMID:: 21704331
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Background: Lung cancer is the second most common neoplasm and the leading cause of cancer deaths in the United States. In cancer, weight loss and obesity are associated with reduced survival. However, the effect of obesity or weight loss at presentation on lung cancer survival has not been well studied.
Materials and Methods: Using an extensive cancer dataset, we identified 76,086 patients diagnosed with lung cancer during the period of 1998-2002, of which 14,751 patients presented with obesity and/or weight loss. We examined the relationship between survival and weight loss or obesity at diagnosis using univariate and multivariate analysis.
Results: Median survival time (MST) for all lung cancer patients was 8.7 mo. Patients presenting with weight loss (15.8%) had shorter MST versus those who did not (6.4 versus 9.2 mo, P < 0.001) and patients with weight loss had significantly shortened MST for all stages and histologic subtypes. In contrast, obese patients at presentation (5.4%) had longer MST relative to non-obese patients (13.0 versus 8.6 mo, P < 0.001), which was significant across all stages and histologic subtypes. Multivariate analysis revealed that the absence of weight loss was an independent, positive predictor of improved survival (HR = 0.087, P < 0.001), while the absence of obesity was an independent predictor of worsened survival in lung cancer (HR = 1.16, P < 0.001).
Conclusions: Our results demonstrate an inverse relationship between survival and weight loss at presentation and a potentially protective effect of obesity in lung cancer survival, which could be due to greater physiologic reserves, thereby prolonging life by slowing the progress of cancer cachexia.
(Copyright © 2011 Elsevier Inc. All rights reserved.)

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