Thomas Aparicio1, Michel Ducreux2, Roger Faroux3, Emilie Barbier4, Sylvain Manfredi5, Thierry Lecomte6, Pierre-Luc Etienne7, Laurent Bedenne5, Jaafar Bennouna8, Jean-Marc Phelip9, Eric François10, Pierre Michel11, Jean-Louis Legoux12, Mohamed Gasmi13, Gilles Breysacher14, Philippe Rougier15, Aimery De Gramont16, Come Lepage5, Olivier Bouché17, Jean-François Seitz18. 1. Gastroenterology Department, CHU Saint Louis, APHP, Paris, France; University Paris 7, Sorbonne Paris Cité, Paris, France. Electronic address: thomas.aparicio@aphp.fr. 2. Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France. 3. Gastroenterology Department, CH La Roche sur Yon, La Roche sur Yon, France. 4. Statistics Department, Fédération Francophone de Cancérologie Digestive, Dijon, France; INSERM UMR 1231, Dijon, France. 5. Univ. Bourgogne Franche-Comté, INSERM UMR1231, Gastroenterology Department, CHU de Dijon, Dijon, France. 6. Gastroenterology Department, CHU Trousseau, Tours, France. 7. Oncology Department, CARIO, HPCA, Plérin, France. 8. Oncology Department, Institut de Cancérologie de L'Ouest, Saint Herblay, France. 9. Gastroenterology Department, CHU Saint Etienne - Hôpital Nord, Saint Priest en Jarez, France. 10. Gastroenterology Department, Centre Antoine Lacassagne, Nice, France. 11. Gastroenterology Department, Rouen University Hospital, CHU Charles Nicolle, Rouen, France. 12. Hepato-Gastroenterology and Digestive Oncology Department, CHR La Source, Orléans, France. 13. Gastroenterology Department, CHU Hôpital Nord, Marseille, France. 14. Gastroenterology Department, CH Pasteur, Colmar, France. 15. Gastroenterology Department, CHU de Nantes, Nantes, France. 16. Oncology Department, Hôpital Franco-Britanique, Levallois Perret, France. 17. Digestive Oncology Department, CHU Robert Debré, Reims, France. 18. Digestive Oncology Department, CHU La Timone, APHM, Aix-Marseille Univ, Marseille, France.
Abstract
BACKGROUND: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in early-stage colorectal cancer (CRC), and low BMI was associated with worse prognosis in metastatic CRC (mCRC). We aimed to assess efficacy outcomes according to BMI. PATIENTS AND METHODS: A pooled analysis of individual data from 2085 patients enrolled in eight FFCD first-line mCRC trials from 1991 to 2013 was performed. Comparisons were made according to the BMI cut-off: Obese (BMI ≥30), overweight patients (BMI ≥ 25), normal BMI patients (BMI: 18.5-24) and thin patients (BMI <18.5). Interaction tests were performed between BMI effect and sex, age and the addition of antiangiogenics to chemotherapy. RESULTS: The rate of BMI ≥25 patients was 41.5%, ranging from 37.6% (1991-1999 period) to 41.5% (2000-2006 period) and 44.8% (2007-2013 period). Comparison of overweight patients versus normal BMI range patients revealed a significant improvement of median overall survival (OS) (18.5 versus 16.3 months, HR = 0.88 [0.80-0.98] p = 0.02) and objective response rate (ORR) (42% versus 36% OR = 1.23 [1.01-1.50] p = 0.04) but a comparable median progression-free survival (PFS) (7.8 versus 7.2 months, HR = 0.96 [0.87-1.05] p = 0.35). Subgroup analyses revealed that overweight was significantly associated with better OS in men. OS and PFS were significantly shorter in thin patients. CONCLUSION: Overweight patients had a prolonged OS compared with normal weight patients with mCRC. The association of overweight with better OS was only observed in men. The pejorative prognosis of BMI <18.5 was confirmed.
BACKGROUND: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in early-stage colorectal cancer (CRC), and low BMI was associated with worse prognosis in metastatic CRC (mCRC). We aimed to assess efficacy outcomes according to BMI. PATIENTS AND METHODS: A pooled analysis of individual data from 2085 patients enrolled in eight FFCD first-line mCRC trials from 1991 to 2013 was performed. Comparisons were made according to the BMI cut-off: Obese (BMI ≥30), overweight patients (BMI ≥ 25), normal BMI patients (BMI: 18.5-24) and thin patients (BMI <18.5). Interaction tests were performed between BMI effect and sex, age and the addition of antiangiogenics to chemotherapy. RESULTS: The rate of BMI ≥25 patients was 41.5%, ranging from 37.6% (1991-1999 period) to 41.5% (2000-2006 period) and 44.8% (2007-2013 period). Comparison of overweight patients versus normal BMI range patients revealed a significant improvement of median overall survival (OS) (18.5 versus 16.3 months, HR = 0.88 [0.80-0.98] p = 0.02) and objective response rate (ORR) (42% versus 36% OR = 1.23 [1.01-1.50] p = 0.04) but a comparable median progression-free survival (PFS) (7.8 versus 7.2 months, HR = 0.96 [0.87-1.05] p = 0.35). Subgroup analyses revealed that overweight was significantly associated with better OS in men. OS and PFS were significantly shorter in thin patients. CONCLUSION: Overweight patients had a prolonged OS compared with normal weight patients with mCRC. The association of overweight with better OS was only observed in men. The pejorative prognosis of BMI <18.5 was confirmed.
Authors: Piotr Spychalski; Jarek Kobiela; Paulina Wieszczy; Michał F Kamiński; Jarosław Reguła Journal: United European Gastroenterol J Date: 2019-03-21 Impact factor: 4.623
Authors: Jacobo Rogado; Nuria Romero-Laorden; José Miguel Sanchez-Torres; Ana María Ramos-Levi; Vilma Pacheco-Barcia; Ana Isabel Ballesteros; Reyes Arranz; Alicia Lorenzo; Pedro Gullon; Ana Garrido; José María Serra López-Matencio; Olga Donnay; Magdalena Adrados; Pablo Costas; Javier Aspa; Arantzazu Alfranca; Rebeca Mondejar; Ramon Colomer Journal: Oncoimmunology Date: 2020-04-16 Impact factor: 8.110