Simon P Gampenrieder1,2, Magdalena Pircher1, Christian Fesl3, Gabriel Rinnerthaler1,2, Brigitte Mlineritsch1, Sigrun Greil-Ressler1, Günther G Steger4, Verena Sagaster4, Florian Fitzal5, Ruth Exner5, Yelena Devyatko5, Marija Balic6, Herbert Stöger6, Christoph Suppan6, Thomas Bauernhofer6, Christian F Singer7, Georg Pfeiler7, Michael Seifert7, Ruth Helfgott8, Dietmar Heck8, Holger Rumpold9, Werner Kwasny10, Ursula Wieder11, Michael Gnant3,5, Richard Greil1,2,3. 1. Department of Internal Medicine III with Haematology, Medical Oncology, Haemostaseology, Infectiology and Rheumatology, Oncologic Center, Salzburg Cancer Research Institute - Laboratory for Immunological and Molecular Cancer Research (SCRI-LIMCR), Paracelsus Medical University Salzburg, Salzburg, Austria. 2. Cancer Cluster Salzburg, Salzburg, Austria. 3. Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria. 4. Department of Internal Medicine 1, Division of Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 5. Department of Surgery and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 6. Division of Oncology, Department of Internal Medicine, Medical University of Graz, Graz, Austria. 7. Department of Obstetrics and Gynecology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria. 8. Department of Surgery and Breast Health Center, Ordensklinikum Linz, Sisters of Charity Linz, Linz, Austria. 9. Department of Internal Medicine 2 with Medical Oncology, Hematology, Gastroenterology and Rheumatology, Academic Teaching Hospital Feldkirch, Feldkirch, Austria. 10. Department of Surgery, Wiener Neustadt Hospital, Vienna, Austria. 11. Department of Surgery, Hanusch Hospital Vienna, Vienna, Austria.
Abstract
Background: Associations between height, cancer risk and worse outcome have been reported for several cancers including breast cancer. We hypothesized that in breast cancer clinical trials, tall women should be overrepresented and might have worse prognosis. Methods: Data of 4,935 women, included from 1990 to 2010 in 5 trials of the Austrian Breast and Colorectal Cancer Study Group (ABCSG), were analyzed retrospectively. The primary objective was to determine differences in height distribution between the ABCSG cohort and the Austrian female population according to a cross-sectional health survey conducted by the Austrian Statistic Center in 2006 and 2007. Secondary endpoints were disease-free survival (DFS) and overall survival (OS) in different height classes and differences of body mass index (BMI) distribution. Results: Breast cancer patients in the ABCSG cohort were only slightly but statistically significantly smaller compared to unselected Austrian adult females (mean 164.3 vs. 164.8 cm; p < 0.0001) and significantly more patients were seen in the lower body height class (50 vs. 46%; p < 0.0001) when using the median as a cutoff. However, after adjustment for age, the difference in body height between the two cohorts was no longer significant (p = 0.089). DFS and OS in the two upper height groups (≥170 cm) compared to the two lowest height groups (<160 cm) was not significantly different (5-year DFS: 84.7 vs. 83.0%; HR 0.91, 95% CI 0.73-1.13, p = 0.379; 5-year OS: 94.8 vs. 91.7%; HR 0.74, 95% CI 0.55-1.00, p = 0.051). The BMI of ABCSG patients was significantly higher than in the reference population (mean BMI 24.64 vs. 23.96; p < 0.0001). Conclusions: Our results do not confirm previous findings that greater body height is associated with a higher breast cancer risk and worse outcome.
Background: Associations between height, cancer risk and worse outcome have been reported for several cancers including breast cancer. We hypothesized that in breast cancer clinical trials, tall women should be overrepresented and might have worse prognosis. Methods: Data of 4,935 women, included from 1990 to 2010 in 5 trials of the Austrian Breast and Colorectal Cancer Study Group (ABCSG), were analyzed retrospectively. The primary objective was to determine differences in height distribution between the ABCSG cohort and the Austrian female population according to a cross-sectional health survey conducted by the Austrian Statistic Center in 2006 and 2007. Secondary endpoints were disease-free survival (DFS) and overall survival (OS) in different height classes and differences of body mass index (BMI) distribution. Results: Breast cancer patients in the ABCSG cohort were only slightly but statistically significantly smaller compared to unselected Austrian adult females (mean 164.3 vs. 164.8 cm; p < 0.0001) and significantly more patients were seen in the lower body height class (50 vs. 46%; p < 0.0001) when using the median as a cutoff. However, after adjustment for age, the difference in body height between the two cohorts was no longer significant (p = 0.089). DFS and OS in the two upper height groups (≥170 cm) compared to the two lowest height groups (<160 cm) was not significantly different (5-year DFS: 84.7 vs. 83.0%; HR 0.91, 95% CI 0.73-1.13, p = 0.379; 5-year OS: 94.8 vs. 91.7%; HR 0.74, 95% CI 0.55-1.00, p = 0.051). The BMI of ABCSG patients was significantly higher than in the reference population (mean BMI 24.64 vs. 23.96; p < 0.0001). Conclusions: Our results do not confirm previous findings that greater body height is associated with a higher breast cancer risk and worse outcome.
Keywords:
Austrian Breast and Colorectal Cancer Study Group; Body mass index; Disease-free survival; Early breast cancer; Height; Outcome; Overall survival; Risk
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