Literature DB >> 29598955

Prognostic Impact of Weight Change During Adjuvant Chemotherapy in Patients With High-Risk Early Breast Cancer: Results From the ADEBAR Study.

Nikola S Mutschler1, Christoph Scholz2, Thomas W P Friedl2, Thomas Zwingers3, Peter A Fasching4, Matthias W Beckmann4, Tanja Fehm5, Svjetlana Mohrmann5, Jessica Salmen5, Carola Ziegler5, Bernadette Jäger5, Peter Widschwendter2, Nikolaus de Gregorio2, Fabienne Schochter2, Sven Mahner6, Nadia Harbeck7, Tobias Weissenbacher6, Julia Jückstock6, Wolfgang Janni2, Brigitte Rack6.   

Abstract

BACKGROUND: In addition to established prognostic factors, individual lifestyle-associated factors, such as obesity, physical activity, and diet, seem to modulate the course of breast cancer. The aim of this analysis was to evaluate the influence of weight changes during adjuvant chemotherapy on outcome in a large multicenter prospectively randomized trial. PATIENTS AND METHODS: The ADEBAR trial compares a sequential chemotherapy consisting of epirubicin/cyclophosphamide followed by docetaxel to an epirubicin/5-fluorouracil/cyclophosphamide regimen in patients with lymph node-positive early breast cancer. Body weight was measured before each cycle of chemotherapy. According to the relative weight change (≥ 5%) between the first and the last cycle, patients were categorized into the weight gain, weight loss, or stable weight group. Overall survival (OS) and disease-free survival were assessed by univariate Kaplan-Meier and multivariate Cox regression analyses.
RESULTS: Concise data from 1080 of 1493 participants who completed all cycles of chemotherapy were available for analysis. Of 307 patients (24.8%) whose weight changed by ≥ 5%, 120 patients (11.1%) lost and 187 (17.3%) gained weight. Multivariate analysis showed a significant independent effect of weight change on OS (P = .039), but not on disease-free survival (P = .111). Both weight change groups had a worse OS compared to patients with stable weight (weight gain: hazard ratio, 1.55; 95% confidence interval, 1.01-2.40; P = .047; weight loss: hazard ratio, 1.55; 95% CI, 0.97-2.47; P = .067).
CONCLUSION: Weight change of > 5% during adjuvant chemotherapy in patients with high-risk early breast cancer is associated with poor OS.
Copyright © 2018 Elsevier Inc. All rights reserved.

Entities:  

Keywords:  breast cancer; chemotherapy; prognosis; survival; weight

Mesh:

Substances:

Year:  2018        PMID: 29598955     DOI: 10.1016/j.clbc.2018.01.008

Source DB:  PubMed          Journal:  Clin Breast Cancer        ISSN: 1526-8209            Impact factor:   3.225


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