Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes

A pooled analysis

Bella Pajares, Marina Pollán, Miguel Martín, John R. Mackey, Ana Lluch, Joaquín Gavila, Charles Vogel, Manuel Ruiz-Borrego, Lourdes Calvo, Tadeusz Pienkowski, Álvaro Rodríguez-Lescure, Miguel A. Seguí, Olivier Tredan, Antonio Antón, Manuel Ramos, María D C Cámara, César Rodríguez-Martín, Eva Carrasco, Emilio Alba

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Introduction: Obesity is an unfavorable prognostic factor in breast cancer (BC) patients regardless of menopausal status and treatment received. However, the association between obesity and survival outcome by pathological subtype requires further clarification.Methods: We performed a retrospective analysis including 5,683 operable BC patients enrolled in four randomized clinical trials (GEICAM/9906, GEICAM/9805, GEICAM/2003-02, and BCIRG 001) evaluating anthracyclines and taxanes as adjuvant treatments. Our primary aim was to assess the prognostic effect of body mass index (BMI) on disease recurrence, breast cancer mortality (BCM), and overall mortality (OM). A secondary aim was to detect differences of such prognostic effects by subtype.Results: Multivariate survival analyses adjusting for age, tumor size, nodal status, menopausal status, surgery type, histological grade, hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, chemotherapy regimen, and under-treatment showed that obese patients (BMI 30.0 to 34.9) had similar prognoses to that of patients with a BMI < 25 (reference group) in terms of recurrence (Hazard Ratio [HR] = 1.08, 95% Confidence Interval [CI] = 0.90 to 1.30), BCM (HR = 1.02, 0.81 to 1.29), and OM (HR = 0.97, 0.78 to 1.19). Patients with severe obesity (BMI ≥ 35) had a significantly increased risk of recurrence (HR = 1.26, 1.00 to 1.59, P = 0.048), BCM (HR = 1.32, 1.00 to 1.74, P = 0.050), and OM (HR = 1.35, 1.06 to 1.71, P = 0.016) compared to our reference group. The prognostic effect of severe obesity did not vary by subtype.Conclusions: Severely obese patients treated with anthracyclines and taxanes present a worse prognosis regarding recurrence, BCM, and OM than patients with BMI < 25. The magnitude of the harmful effect of BMI on survival-related outcomes was similar across subtypes.

Original languageEnglish
Article numberR105
JournalBreast Cancer Research
Volume15
Issue number6
DOIs
StatePublished - Nov 6 2013

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Taxoids
Anthracyclines
Obesity
Breast Neoplasms
Body Mass Index
Survival
Mortality
Recurrence
Morbid Obesity
Survival Analysis
Therapeutics
Multivariate Analysis
Randomized Controlled Trials
Hormones
Confidence Intervals
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes : A pooled analysis. / Pajares, Bella; Pollán, Marina; Martín, Miguel; Mackey, John R.; Lluch, Ana; Gavila, Joaquín; Vogel, Charles; Ruiz-Borrego, Manuel; Calvo, Lourdes; Pienkowski, Tadeusz; Rodríguez-Lescure, Álvaro; Seguí, Miguel A.; Tredan, Olivier; Antón, Antonio; Ramos, Manuel; Cámara, María D C; Rodríguez-Martín, César; Carrasco, Eva; Alba, Emilio.

In: Breast Cancer Research, Vol. 15, No. 6, R105, 06.11.2013.

Research output: Contribution to journalArticle

Pajares, B, Pollán, M, Martín, M, Mackey, JR, Lluch, A, Gavila, J, Vogel, C, Ruiz-Borrego, M, Calvo, L, Pienkowski, T, Rodríguez-Lescure, Á, Seguí, MA, Tredan, O, Antón, A, Ramos, M, Cámara, MDC, Rodríguez-Martín, C, Carrasco, E & Alba, E 2013, 'Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes: A pooled analysis', Breast Cancer Research, vol. 15, no. 6, R105. https://doi.org/10.1186/bcr3572
Pajares, Bella ; Pollán, Marina ; Martín, Miguel ; Mackey, John R. ; Lluch, Ana ; Gavila, Joaquín ; Vogel, Charles ; Ruiz-Borrego, Manuel ; Calvo, Lourdes ; Pienkowski, Tadeusz ; Rodríguez-Lescure, Álvaro ; Seguí, Miguel A. ; Tredan, Olivier ; Antón, Antonio ; Ramos, Manuel ; Cámara, María D C ; Rodríguez-Martín, César ; Carrasco, Eva ; Alba, Emilio. / Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes : A pooled analysis. In: Breast Cancer Research. 2013 ; Vol. 15, No. 6.
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abstract = "Introduction: Obesity is an unfavorable prognostic factor in breast cancer (BC) patients regardless of menopausal status and treatment received. However, the association between obesity and survival outcome by pathological subtype requires further clarification.Methods: We performed a retrospective analysis including 5,683 operable BC patients enrolled in four randomized clinical trials (GEICAM/9906, GEICAM/9805, GEICAM/2003-02, and BCIRG 001) evaluating anthracyclines and taxanes as adjuvant treatments. Our primary aim was to assess the prognostic effect of body mass index (BMI) on disease recurrence, breast cancer mortality (BCM), and overall mortality (OM). A secondary aim was to detect differences of such prognostic effects by subtype.Results: Multivariate survival analyses adjusting for age, tumor size, nodal status, menopausal status, surgery type, histological grade, hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, chemotherapy regimen, and under-treatment showed that obese patients (BMI 30.0 to 34.9) had similar prognoses to that of patients with a BMI < 25 (reference group) in terms of recurrence (Hazard Ratio [HR] = 1.08, 95{\%} Confidence Interval [CI] = 0.90 to 1.30), BCM (HR = 1.02, 0.81 to 1.29), and OM (HR = 0.97, 0.78 to 1.19). Patients with severe obesity (BMI ≥ 35) had a significantly increased risk of recurrence (HR = 1.26, 1.00 to 1.59, P = 0.048), BCM (HR = 1.32, 1.00 to 1.74, P = 0.050), and OM (HR = 1.35, 1.06 to 1.71, P = 0.016) compared to our reference group. The prognostic effect of severe obesity did not vary by subtype.Conclusions: Severely obese patients treated with anthracyclines and taxanes present a worse prognosis regarding recurrence, BCM, and OM than patients with BMI < 25. The magnitude of the harmful effect of BMI on survival-related outcomes was similar across subtypes.",
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T1 - Obesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes

T2 - A pooled analysis

AU - Pajares, Bella

AU - Pollán, Marina

AU - Martín, Miguel

AU - Mackey, John R.

AU - Lluch, Ana

AU - Gavila, Joaquín

AU - Vogel, Charles

AU - Ruiz-Borrego, Manuel

AU - Calvo, Lourdes

AU - Pienkowski, Tadeusz

AU - Rodríguez-Lescure, Álvaro

AU - Seguí, Miguel A.

AU - Tredan, Olivier

AU - Antón, Antonio

AU - Ramos, Manuel

AU - Cámara, María D C

AU - Rodríguez-Martín, César

AU - Carrasco, Eva

AU - Alba, Emilio

PY - 2013/11/6

Y1 - 2013/11/6

N2 - Introduction: Obesity is an unfavorable prognostic factor in breast cancer (BC) patients regardless of menopausal status and treatment received. However, the association between obesity and survival outcome by pathological subtype requires further clarification.Methods: We performed a retrospective analysis including 5,683 operable BC patients enrolled in four randomized clinical trials (GEICAM/9906, GEICAM/9805, GEICAM/2003-02, and BCIRG 001) evaluating anthracyclines and taxanes as adjuvant treatments. Our primary aim was to assess the prognostic effect of body mass index (BMI) on disease recurrence, breast cancer mortality (BCM), and overall mortality (OM). A secondary aim was to detect differences of such prognostic effects by subtype.Results: Multivariate survival analyses adjusting for age, tumor size, nodal status, menopausal status, surgery type, histological grade, hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, chemotherapy regimen, and under-treatment showed that obese patients (BMI 30.0 to 34.9) had similar prognoses to that of patients with a BMI < 25 (reference group) in terms of recurrence (Hazard Ratio [HR] = 1.08, 95% Confidence Interval [CI] = 0.90 to 1.30), BCM (HR = 1.02, 0.81 to 1.29), and OM (HR = 0.97, 0.78 to 1.19). Patients with severe obesity (BMI ≥ 35) had a significantly increased risk of recurrence (HR = 1.26, 1.00 to 1.59, P = 0.048), BCM (HR = 1.32, 1.00 to 1.74, P = 0.050), and OM (HR = 1.35, 1.06 to 1.71, P = 0.016) compared to our reference group. The prognostic effect of severe obesity did not vary by subtype.Conclusions: Severely obese patients treated with anthracyclines and taxanes present a worse prognosis regarding recurrence, BCM, and OM than patients with BMI < 25. The magnitude of the harmful effect of BMI on survival-related outcomes was similar across subtypes.

AB - Introduction: Obesity is an unfavorable prognostic factor in breast cancer (BC) patients regardless of menopausal status and treatment received. However, the association between obesity and survival outcome by pathological subtype requires further clarification.Methods: We performed a retrospective analysis including 5,683 operable BC patients enrolled in four randomized clinical trials (GEICAM/9906, GEICAM/9805, GEICAM/2003-02, and BCIRG 001) evaluating anthracyclines and taxanes as adjuvant treatments. Our primary aim was to assess the prognostic effect of body mass index (BMI) on disease recurrence, breast cancer mortality (BCM), and overall mortality (OM). A secondary aim was to detect differences of such prognostic effects by subtype.Results: Multivariate survival analyses adjusting for age, tumor size, nodal status, menopausal status, surgery type, histological grade, hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, chemotherapy regimen, and under-treatment showed that obese patients (BMI 30.0 to 34.9) had similar prognoses to that of patients with a BMI < 25 (reference group) in terms of recurrence (Hazard Ratio [HR] = 1.08, 95% Confidence Interval [CI] = 0.90 to 1.30), BCM (HR = 1.02, 0.81 to 1.29), and OM (HR = 0.97, 0.78 to 1.19). Patients with severe obesity (BMI ≥ 35) had a significantly increased risk of recurrence (HR = 1.26, 1.00 to 1.59, P = 0.048), BCM (HR = 1.32, 1.00 to 1.74, P = 0.050), and OM (HR = 1.35, 1.06 to 1.71, P = 0.016) compared to our reference group. The prognostic effect of severe obesity did not vary by subtype.Conclusions: Severely obese patients treated with anthracyclines and taxanes present a worse prognosis regarding recurrence, BCM, and OM than patients with BMI < 25. The magnitude of the harmful effect of BMI on survival-related outcomes was similar across subtypes.

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