@article{19815217abc44fbebe1614c326fe55b7,
title = "Body Mass Index (BMI), BMI Change, and Overall Survival in Patients With SCLC and NSCLC: A Pooled Analysis of the International Lung Cancer Consortium",
abstract = "Introduction: The relationships between morbid obesity, changes in body mass index (BMI) before cancer diagnosis, and lung cancer outcomes by histology (SCLC and NSCLC) have not been well studied. Methods: Individual level data analysis was performed on 25,430 patients with NSCLC and 2787 patients with SCLC from 16 studies of the International Lung Cancer Consortium evaluating the association between various BMI variables and lung cancer overall survival, reported as adjusted hazard ratios (aHRs) from Cox proportional hazards models and adjusted penalized smoothing spline plots. Results: Overall survival of NSCLC had putative U-shaped hazard ratio relationships with BMI based on spline plots: being underweight (BMI < 18.5 kg/m2; aHR = 1.56; 95% confidence interval [CI]:1.43–1.70) or morbidly overweight (BMI > 40 kg/m2; aHR = 1.09; 95% CI: 0.95–1.26) at the time of diagnosis was associated with worse stage-specific prognosis, whereas being overweight (25 kg/m2 ≤ BMI < 30 kg/m2; aHR = 0.89; 95% CI: 0.85–0.95) or obese (30 kg/m2 ≤ BMI ≤ 40 kg/m2; aHR = 0.86; 95% CI: 0.82–0.91) was associated with improved survival. Although not significant, a similar pattern was seen with SCLC. Compared with an increased or stable BMI from the period between young adulthood until date of diagnosis, a decreased BMI was associated with worse outcomes in NSCLC (aHR = 1.24; 95% CI: 1.2–1.3) and SCLC patients (aHR=1.26 (95% CI: 1.0–1.6). Decreased BMI was consistently associated with worse outcome, across clinicodemographic subsets. Conclusions: Both being underweight or morbidly obese at time of diagnosis is associated with lower stage-specific survival in independent assessments of NSCLC and SCLC patients. In addition, a decrease in BMI at lung cancer diagnosis relative to early adulthood is a consistent marker of poor survival.",
keywords = "Body mass index, Lung cancer, Survival",
author = "Daniel Shepshelovich and Wei Xu and Lin Lu and Aline Fares and Ping Yang and David Christiani and Jie Zhang and Kouya Shiraishi and Ryan, {Brid M.} and Chu Chen and Schwartz, {Ann G.} and Adonina Tardon and Xifeng Wu and Schabath, {Matthew B.} and Teare, {M. Dawn} and {Le Marchand}, Loic and Zhang, {Zuo Feng} and Field, {John K.} and Hermann Brenner and Nancy Diao and Juntao Xie and Takashi Kohno and Harris, {Curtis C.} and Wenzlaff, {Angela S.} and Guillermo Fernandez-Tardon and Yuanqing Ye and Fiona Taylor and Wilkens, {Lynne R.} and Michael Davies and Yi Liu and Barnett, {Matt J.} and Goodman, {Gary E.} and Hal Morgenstern and Bernd Holleczek and Brown, {M. Catherine} and Geoffrey Liu and Hung, {Rayjean J.}",
note = "Funding Information: Drs. Shepshelovich, Fares, Brown, and G. Liu were supported by funding from the Alan Brown Chair in Molecular Genomics, the Posluns Family Fund , and the Lusi Wong Fund. Drs. Schwartz and Wenzlaff and data collection at Karmanos were supported by National Institutes of Health (NIH) grants and contracts R01CA60691 , R01CA87895 , P30CA022453 , and HHSN261201300011I . CARET is funded by the National Cancer Institute (NCI), NIH through grants U01-CA063673 , UM1-CA167462 , and U01-CA167462 . Drs. Z. Zhang and Morgenstern were supported by DA/CA11386 and CA90833. Drs. Shirashi and Kohno were supported by the Health and Labour Sciences Research Grant. Drs. Ryan and Harris were supported by the Intramural Research Program of the Center for Cancer Research , NCI. Funding Information: Drs. Shepshelovich, Fares, Brown, and G. Liu were supported by funding from the Alan Brown Chair in Molecular Genomics, the Posluns Family Fund, and the Lusi Wong Fund. Drs. Schwartz and Wenzlaff and data collection at Karmanos were supported by National Institutes of Health (NIH) grants and contracts R01CA60691, R01CA87895, P30CA022453, and HHSN261201300011I. CARET is funded by the National Cancer Institute (NCI), NIH through grants U01-CA063673, UM1-CA167462, and U01-CA167462. Drs. Z. Zhang and Morgenstern were supported by DA/CA11386 and CA90833. Drs. Shirashi and Kohno were supported by the Health and Labour Sciences Research Grant. Drs. Ryan and Harris were supported by the Intramural Research Program of the Center for Cancer Research, NCI. Publisher Copyright: {\textcopyright} 2019 International Association for the Study of Lung Cancer",
year = "2019",
month = sep,
doi = "10.1016/j.jtho.2019.05.031",
language = "English (US)",
volume = "14",
pages = "1594--1607",
journal = "Journal of Thoracic Oncology",
issn = "1556-0864",
publisher = "International Association for the Study of Lung Cancer",
number = "9",
}