학술논문
The relationship between body-mass index and overall survival in non-small cell lung cancer by sex, smoking status, and race: A pooled analysis of 20,937 International lung Cancer consortium (ILCCO) patients
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article
Author
Jiang, Mei; Fares, Aline F; Shepshelovich, Daniel; Yang, Ping; Christiani, David; Zhang, Jie; Shiraishi, Kouya; Ryan, Brid M; Chen, Chu; Schwartz, Ann G; Tardon, Adonina; Shete, Sanjay; Schabath, Matthew B; Teare, M Dawn; Le Marchand, Loic; Zhang, Zuo-Feng; Field, John K; Brenner, Hermann; Diao, Nancy; Xie, Juntao; Kohno, Takashi; Harris, Curtis C; Wenzlaff, Angela S; Fernandez-Tardon, Guillermo; Ye, Yuanqing; Taylor, Fiona; Wilkens, Lynne R; Davies, Michael; Liu, Yi; Barnett, Matt J; Goodman, Gary E; Morgenstern, Hal; Holleczek, Bernd; Thomas, Sera; Brown, M Catherine; Hung, Rayjean J; Xu, Wei; Liu, Geoffrey
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Abstract
IntroductionThe relationship between Body-Mass-Index (BMI) and lung cancer prognosis is heterogeneous. We evaluated the impact of sex, smoking and race on the relationship between BMI and overall survival (OS) in non-small-cell-lung-cancer (NSCLC).MethodsData from 16 individual ILCCO studies were pooled to assess interactions between BMI and the following factors on OS: self-reported race, smoking status and sex, using Cox models (adjusted hazard ratios; aHR) with interaction terms and adjusted penalized smoothing spline plots in stratified analyses.ResultsAmong 20,937 NSCLC patients with BMI values, females = 47 %; never-smokers = 14 %; White-patients = 76 %. BMI showed differential survival according to race whereby compared to normal-BMI patients, being underweight was associated with poor survival among white patients (OS, aHR = 1.66) but not among black patients (aHR = 1.06; pinteraction = 0.02). Comparing overweight/obese to normal weight patients, Black NSCLC patients who were overweight/obese also had relatively better OS (pinteraction = 0.06) when compared to White-patients. BMI was least associated with survival in Asian-patients and never-smokers. The outcomes of female ever-smokers at the extremes of BMI were associated with worse outcomes in both the underweight (pinteraction