Sylvain Ladoire1, Cecile Dalban2, Henri Roché3, Marc Spielmann4, Pierre Fumoleau5, Christelle Levy6, Anne Laure Martin7, Fiona Ecarnot8, Frank Bonnetain9, François Ghiringhelli10. 1. Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France; Institut National de la Santé et de la Recherche Médicale (INSERM), CRI-866 Faculty of Medicine, Dijon, France; University of Burgundy, Dijon, France. 2. Biostatistics and Epidemiological Unit, EA 4184, Centre Georges François Leclerc, Dijon, France. 3. Department of Medical Oncology, Institut Claudius Regaud, Toulouse, France. 4. Department of Medicine and Translational Research Unit, Institut Gustave Roussy, Villejuif, France. 5. Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France; University of Burgundy, Dijon, France. 6. Department of Medical Oncology, Centre François Baclesse, Caen, France. 7. Fédération Nationale des Centres de Lutte Contre le Cancer, Paris, France. 8. EA3920, University of Franche-Comté, Besancon, France. 9. Methodology and Quality of Life in Oncology Unit, EA 3181, Quality of Life and Cancer Clinical Research Platform, University Hospital, Besancon, France. 10. Department of Medical Oncology, Centre Georges-François Leclerc, Dijon, France; Institut National de la Santé et de la Recherche Médicale (INSERM), CRI-866 Faculty of Medicine, Dijon, France; University of Burgundy, Dijon, France. Electronic address: fghiringhelli@cgfl.fr.
Abstract
BACKGROUND: To examine the association between baseline body mass index (BMI), and disease-free survival (DFS) and overall survival (OS) in a large French early-stage breast cancer population included in the UNICANCER Programme d'Action Concerté Sein-01 (PACS01) and PACS04 phase III randomised trials. METHODS: After a median follow-up of 5.9years, this report analyses 4996 patients with node-positive breast cancer, and randomly assigned to adjuvant anthracycline-based chemotherapy combined or not with taxanes. Univariate analyses were used to study the effects of well known prognostic factors and BMI on DFS and OS. BMI was obtained at baseline, before chemotherapy initiation, and obesity was defined as a BMI⩾30kg/m(2). Cox proportional hazards regression models were secondly used to assess the influence of BMI after adjusting for other factors. Exhaustive analysis of the dose intensity delivered was also studied for comparison between obese and non-obese patients. RESULTS:Obese patients initially present with more advanced disease at diagnosis compared to non-obese patients. By univariate analysis, obesity was moderately associated with poorer DFS (hazard ratio (HR)=1.18 [1.01-1.39] P=0.04), but mostly with poorer OS (HR=1.38 [1.13-1.69] P=0.002). Delivered dose intensity of anthracyclines and taxanes was not significantly different between obese and non-obese patients. After adjustment for disease characteristics, BMI had no influence either on DFS or OS. CONCLUSION: This report suggests that in a French population, obesity has no impact on breast cancer prognosis when modern adjuvant chemotherapy, at the appropriate dose intensity, is delivered.
RCT Entities:
BACKGROUND: To examine the association between baseline body mass index (BMI), and disease-free survival (DFS) and overall survival (OS) in a large French early-stage breast cancer population included in the UNICANCER Programme d'Action Concerté Sein-01 (PACS01) and PACS04 phase III randomised trials. METHODS: After a median follow-up of 5.9years, this report analyses 4996 patients with node-positive breast cancer, and randomly assigned to adjuvant anthracycline-based chemotherapy combined or not with taxanes. Univariate analyses were used to study the effects of well known prognostic factors and BMI on DFS and OS. BMI was obtained at baseline, before chemotherapy initiation, and obesity was defined as a BMI⩾30kg/m(2). Cox proportional hazards regression models were secondly used to assess the influence of BMI after adjusting for other factors. Exhaustive analysis of the dose intensity delivered was also studied for comparison between obese and non-obesepatients. RESULTS:Obesepatients initially present with more advanced disease at diagnosis compared to non-obesepatients. By univariate analysis, obesity was moderately associated with poorer DFS (hazard ratio (HR)=1.18 [1.01-1.39] P=0.04), but mostly with poorer OS (HR=1.38 [1.13-1.69] P=0.002). Delivered dose intensity of anthracyclines and taxanes was not significantly different between obese and non-obesepatients. After adjustment for disease characteristics, BMI had no influence either on DFS or OS. CONCLUSION: This report suggests that in a French population, obesity has no impact on breast cancer prognosis when modern adjuvant chemotherapy, at the appropriate dose intensity, is delivered.
Authors: Il Yong Chung; Jong Won Lee; Ji Sung Lee; Yu Rang Park; Yul Ha Min; Yura Lee; Tae In Yoon; Guiyun Sohn; Sae Byul Lee; Jisun Kim; Hee Jeong Kim; Beom Seok Ko; Byung Ho Son; Sei Hyun Ahn Journal: PLoS One Date: 2017-03-01 Impact factor: 3.240