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Decreased body mass index is associated with impaired survival in lung cancer patients with brain metastases: A retrospective analysis of 624 patients
Author(s) -
Masel E.K.,
Berghoff A.S.,
Füreder L.M.,
Heicappell P.,
Schlieter F.,
Widhalm G.,
Gatterbauer B.,
Dieckmann U.,
Birner P.,
Bartsch R.,
Schur S.,
Watzke H.H.,
Zielinski C.C.,
Preusser M.
Publication year - 2017
Publication title -
european journal of cancer care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.849
H-Index - 67
eISSN - 1365-2354
pISSN - 0961-5423
DOI - 10.1111/ecc.12707
Subject(s) - medicine , underweight , body mass index , overweight , lung cancer , proportional hazards model , multivariate analysis , cancer , hazard ratio , gastroenterology , oncology , confidence interval
Body mass index ( BMI ) is a prognostic factor in several cancer types. We investigated the prognostic role of BMI in a large patient cohort with newly diagnosed lung cancer brain metastases ( BM ) between 1990 and 2013. BMI at diagnosis of BM and graded prognostic assessment ( GPA ) were calculated. Definitions were underweight ( BMI <18.50), weight within normal range ( BMI 18.50–24.99) and overweight ( BMI ≥ 25.00). A total of 624 patients (men 401/624 [64.3%]; women 223/624 [35.7%]; median age of 61 [range 33–88]) were analysed. Histology was non‐small cell lung cancer in 417/622 (66.8%), small cell lung cancer ( SCLC ) in 205/624 (32.9%) and not otherwise specified in 2/624 (0.3%) patients. About 313/624 (50.2%) had normal BMI , 272/624 (43.5%) were overweight and 39/624 (6.3%) were underweight. Underweight patients had shorter median overall survival (3 months) compared to patients with normal BMI (7 months) and overweight (8 months; p < .001; log rank test). At multivariate analysis, higher GPA class ( HR 1.430; 95% cumulative incidence, CI 1.279–1.598; p < .001; Cox regression model), SCLC histology ( HR 1.310; 95% CI 1.101–1.558) and presence of underweight ( HR 1.845; 95% CI 1.317–2.585; p = .014; Cox regression model) were independent prognostic factors. Underweight at diagnosis of BM in lung cancer is associated with an unfavourable prognosis.