The Influence of Body Mass Index on Overall Survival Following Surgical Resection of Non-Small Cell Lung Cancer.

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The Influence of Body Mass Index on Overall Survival Following Surgical Resection of Non-Small Cell Lung Cancer.

J Thorac Oncol. 2017 May 25;:

Authors: Sepesi B, Gold KA, Correa AM, Heymach JV, Vaporciyan AA, Roszik J, Dmitrovsky E, Liu X

Abstract
BACKGROUND: Population studies suggest that high body mass index (BMI) correlates with a reduced risk of death from lung cancer. The aim of our study was to evaluate definitively the influence of BMI on long term overall survival (OS) in surgical patients with non-small cell lung cancer (NSCLC).
METHODS: Study population consisted of 1935 patients who underwent surgical resection for lung cancer at MD Anderson Cancer Center (2000-2014). Study variables included both patient and treatment related characteristics. Univariate and multivariate Cox regression analyses were performed to identify variables associated with overall survival.
RESULTS: On univariate analysis, significant predictors of improved survival were higher BMI, pathologic tumor stage (stage I vs II, III, or IV), type of surgery (lobectomy/pneumonectomy versus wedge resection/segmentectomy), younger age, female gender, and adenocarcinoma histology (versus squamous) (all p<0.05, Table 2 and 3). Morbidly obese patients (BMI≥35) had a trend towards better outcomes than those classified as obese (BMI ≥30 and <35) (p=0.05), overweight (BMI ≥25 and <30) (p=0.13), or healthy weight (BMI <25) (p=0.37) (HR 0.727, 0.848, 0.926, and 1, respectively). On multivariate analysis, BMI remained an independent predictor of survival (p=0.02). Propensity matching analysis demonstrated significantly better OS (p=0.003) in patients with BMI≥30 as compared to BMI 25.
CONCLUSIONS: In this large, retrospective, single center series, after controlling for disease stage and other variables, higher BMI was associated with improved OS following surgical resection of NSCLC. Further studies are necessary to elucidate the precise relationship between BMI and treatment outcomes.

PMID: 28552766 [PubMed - as supplied by publisher]

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