Does body mass index affect progression-free or overall survival in patients with ovarian cancer? Results from SCOTROC I trial

Barrett, Sophie; Paul, Jim; Hay, A.; Vasey, P.; Kaye, Stanley B.; Glasspool, Rosalind

doi:10.1093/annonc/mdm606

Cited by 74 publications

(57 citation statements)

References 16 publications

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“…Sample size ranged from 74 to 1,067, with a median of 350. The majority of the studies were observational cohorts; however, 3 were cohorts of women with ovarian cancer participating in randomized trials (9,24,25).…”

Section: Systematic Reviewmentioning

confidence: 99%

“…Five studies used data on height and weight obtained 1 year before diagnosis (26) or from reports of women's usual adult weight (27)(28)(29)(30), 4 studies measured BMI at the time of diagnosis (10, 13, 14, 31), 8 at the commencement of chemotherapy (9,11,15,20,24,25,32,33), 1 study did not state when BMI was measured (34), and 2 studies assessed BMI at multiple time points (12,35) including 5 years before diagnosis (12,35 (13,24,26,27,34) whereas others used variations including all women with a BMI < 20 or BMI < 25. Median follow-up time varied considerably between studies ranging from less than 1 year to greater than 10 years.…”

Section: Systematic Reviewmentioning

confidence: 99%

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Obesity and Ovarian Cancer Survival: A Systematic Review and Meta-analysis

Protani

Nagle

Webb

2012

Cancer Prevention Research

131

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Studies that have examined the association between obesity and ovarian cancer survival have provided conflicting results. We reviewed and quantitatively summarized existing evidence, exploring potentially important sources of variability, such as the timing of body mass index (BMI) assessment and different cutpoints used to categorize BMI. A systematic search of MEDLINE and EMBASE was conducted to identify original data evaluating the association between obesity and survival in women with ovarian cancer. Adjusted hazard ratios (HR) from studies were pooled using a random-effects model. The meta-analysis of 14 studies showed slightly poorer survival among obese than in non-obese women [pooled HR, 1.17; 95% confidence interval (CI), 1.03-1.34]. This estimate did not vary appreciably when BMI was measured before diagnosis (1.13; 0.95-1.35), at the time of diagnosis (1.13; 0.81-1.57) or at the commencement of chemotherapy (1.12; 0.96-1.31). We found a slightly stronger association in studies that only included women with a BMI 30 in their "obese" group (1.20) than in studies that also included overweight women (BMI 25; 1.14). Women with ovarian cancer who are obese appear to have slightly worse survival than non-obese women. However, there is a large amount of inter-study variation, which means that no solid conclusions can be drawn. Cancer Prev Res; 5(7); 901-10. Ó2012 AACR.

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Section: Systematic Reviewmentioning

confidence: 99%

Section: Systematic Reviewmentioning

confidence: 99%

Obesity and Ovarian Cancer Survival: A Systematic Review and Meta-analysis

Protani

Nagle

Webb

2012

Cancer Prevention Research

131

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“…Recent studies demonstrated no significant correlation between BMI and survival rate in patients with ovarian, colon, and prostate cancer. [3][4][5][6] In 2009, approximately 16,000 new cases and 14,000 deaths from esophageal cancer (EC) were estimated to have occurred in the United States. 7 In the West, the incidence of esophageal adenocarcinoma (EAC) has been rising dramatically and that of squamous cell carcinoma (SCC) has been subsiding, with approximately 80% of new cases being diagnosed as EAC.…”

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confidence: 99%

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

Hayashi¹,

Correa²,

Hofstetter³

et al. 2010

Cancer

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BACKGROUND: High body mass index (BMI), a prevalent condition in the United States, is associated with esophageal adenocarcinoma (EAC). Its influence on a patient's outcome remains unclear. In the current study, the authors examined the impact of BMI on survival and complications in patients with esophageal cancer (EC) who underwent surgery as their primary therapy. METHODS: The authors retrospectively reviewed 301 consecutive EC patients who underwent surgery but received no adjunctive therapy. Patients were segregated into 2 subgroups based on their baseline BMI: normal/low (<25 kg/m 2 ) and high ( 25 kg/m 2 ). RESULTS: Seventy-six (25%) patients had a BMI <25 kg/m 2 and 225 (75%) patients had a BMI 25 kg/m 2 . In the high BMI group, there were more men (P < .001), fewer upper ECs (P ¼ .021), a lower baseline clinical stage (P ¼ .006), and frequent EAC (P < .001). Postoperative morbidity was similar in both groups, with the exception of gastrointestinal complications (P ¼ .016). The 5-year overall survival (OS) rates were 44% in the normal/low BMI group and 60% in the high BMI group (P ¼ .017). The 5-year disease-free survival (DFS) rates were 41% in the normal/low BMI group and 60% in the high BMI group (P ¼ .005). On multivariable analysis, age, weight loss, peripheral vascular disease (PVD), and both clinical and pathological stage of disease were found to be independent prognosticators for OS. Older age (hazard ratio [HR]

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“…The ASCO guidelines recommend that obese adult patients with cancer should be treated with chemotherapy doses based on ABW, especially when the goal of treatment is cure. No evidence shows that obese patients receiving chemotherapy would experience increased toxicity if actual weight were used to calculate the dose [13][14][15][16][17][18][19][20][21]. Clinicians should address treatment-related toxicities in obese patients in the same manner that they would for nonobese patients.…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy Dose Adjustment for Obese Patients Undergoing Hematopoietic Stem Cell Transplantation: A Survey on Behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

Shem‐Tov

Labopin²,

Moukhtari³

et al. 2014

The Oncologist

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Background. Appropriate chemotherapy dosing for obese patients with malignant diseases is a significant challenge because limiting chemotherapy doses in these patients may negatively influence outcome. There is a paucity of information addressing high‐dose chemotherapy in obese patients undergoing hematopoietic stem cell transplantation (HSCT). Methods. The Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation (EBMT) designed an electronic survey to assess current practice of dose adjustment of chemotherapy in obese patients undergoing HSCT. Results. A total of 56 EBMT centers from 27 countries responded to the online survey. Overall, 45 centers declared that they routinely adjust chemotherapy doses for obese patients (80.5%), and only 11 (19.5%) declared they do not adjust dose. Among the former group, most used body mass index as the parameter for defining obesity (28 centers, 62%). The method for determining the weight for chemotherapy calculation was actual body weight (ABW) in 16 centers, ideal body weight (IBW) in 10 centers, IBW plus 25% of the difference between IBW and ABW in 16 centers, and other methods for the rest. Among centers that used dose adjustment, 44% also capped the dose at 2 m2 for a chemotherapy dose based on body surface area (BSA), whereas 56% did not cap. Interestingly, most of the centers (9 of 11) that did not adjust dose for weight also did not cap the BSA at 2 m2. Conclusion. This EBMT survey revealed large diversity among transplant centers regarding dose‐adjustment practice for high‐dose conditioning chemotherapy. Our next step is to analyze outcomes of transplantation according to dose‐adjustment practice and, subsequently, to formulate a methodology for future prospective studies.

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Does body mass index affect progression-free or overall survival in patients with ovarian cancer? Results from SCOTROC I trial

Abstract: Obese patients with epithelial ovarian cancer do not have a poorer prognosis, provided that they receive optimal doses of chemotherapy based on measured GFR and actual body weight.

Cited by 74 publications

References 16 publications

Obesity and Ovarian Cancer Survival: A Systematic Review and Meta-analysis

Obesity and Ovarian Cancer Survival: A Systematic Review and Meta-analysis

The influence of high body mass index on the prognosis of patients with esophageal cancer after surgery as primary therapy

Chemotherapy Dose Adjustment for Obese Patients Undergoing Hematopoietic Stem Cell Transplantation: A Survey on Behalf of the Acute Leukemia Working Party of the European Society for Blood and Marrow Transplantation

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