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

Mei Jiang; Aline F. Fares; Daniel Shepshelovich; Ping Yang; David Christiani; Jie Zhang; Kouya Shiraishi; Brid M. Ryan; Chu Chen; Ann G. Schwartz; Adonina Tardon; Sanjay Shete; Matthew B. Schabath; M. Dawn Teare; Loic Le Marchand; Zuo Feng Zhang; John K. Field; Hermann Brenner; Nancy Diao; Juntao Xie; Takashi Kohno; Curtis C. Harris; Angela S. Wenzlaff; Guillermo Fernandez-Tardon; Yuanqing Ye; Fiona Taylor; Lynne R. Wilkens; Michael Davies; Yi Liu; Matt J. Barnett; Gary E. Goodman; Hal Morgenstern; Bernd Holleczek; Sera Thomas; M. Catherine Brown; Rayjean J. Hung; Wei Xu; Geoffrey Liu

doi:10.1016/j.lungcan.2020.11.029

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

Mei Jiang, Aline F. Fares, Daniel Shepshelovich, Ping Yang, David Christiani, Jie Zhang, Kouya Shiraishi, Brid M. Ryan, Chu Chen, Ann G. Schwartz, Adonina Tardon, Sanjay Shete, Matthew B. Schabath, M. Dawn Teare, Loic Le Marchand, Zuo Feng Zhang, John K. Field, Hermann Brenner, Nancy Diao, Juntao XieTakashi Kohno, Curtis C. Harris, Angela S. Wenzlaff, Guillermo Fernandez-Tardon, Yuanqing Ye, Fiona Taylor, Lynne R. Wilkens, Michael Davies, Yi Liu, Matt J. Barnett, Gary E. Goodman, Hal Morgenstern, Bernd Holleczek, Sera Thomas, M. Catherine Brown, Rayjean J. Hung, Wei Xu, Geoffrey Liu

Quantitative Health Sciences

Research output: Contribution to journal › Article › peer-review

3 Scopus citations

Abstract

Introduction: The 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). Methods: Data 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. Results: Among 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; p_interaction = 0.02). Comparing overweight/obese to normal weight patients, Black NSCLC patients who were overweight/obese also had relatively better OS (p_interaction = 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 (p_interaction<0.001) and obese categories (p_interaction = 0.004) relative to the normal-BMI category, when compared to male ever-smokers. Conclusion: Underweight and obese female ever-smokers were associated with worse outcomes in White-patients. These BMI associations were not observed in Asian-patients and never-smokers. Black-patients had more favorable outcomes in the extremes of BMI when compared to White-patients. Body composition in Black-patients, and NSCLC subtypes more commonly seen in Asian-patients and never-smokers, may account for differences in these BMI-OS relationships.

Original language	English (US)
Pages (from-to)	58-65
Number of pages	8
Journal	Lung Cancer
Volume	152
DOIs	https://doi.org/10.1016/j.lungcan.2020.11.029
State	Published - Feb 2021

Keywords

Body mass index
Interaction
Lung cancer
Obesity

ASJC Scopus subject areas

Oncology
Pulmonary and Respiratory Medicine
Cancer Research

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10.1016/j.lungcan.2020.11.029

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Jiang, M., Fares, A. F., Shepshelovich, D., Yang, P., Christiani, D., Zhang, J., Shiraishi, K., Ryan, B. M., Chen, C., Schwartz, A. G., Tardon, A., Shete, S., Schabath, M. B., Teare, M. D., Le Marchand, L., Zhang, Z. F., Field, J. K., Brenner, H., Diao, N., ... Liu, G. (2021). 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. Lung Cancer, 152, 58-65. https://doi.org/10.1016/j.lungcan.2020.11.029

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. / Jiang, Mei; Fares, Aline F.; Shepshelovich, Daniel et al.
In: Lung Cancer, Vol. 152, 02.2021, p. 58-65.

Research output: Contribution to journal › Article › peer-review

Jiang, M, Fares, AF, Shepshelovich, D, Yang, P, Christiani, D, Zhang, J, Shiraishi, K, Ryan, BM, Chen, C, Schwartz, AG, Tardon, A, Shete, S, Schabath, MB, Teare, MD, Le Marchand, L, Zhang, ZF, Field, JK, Brenner, H, Diao, N, Xie, J, Kohno, T, Harris, CC, Wenzlaff, AS, Fernandez-Tardon, G, Ye, Y, Taylor, F, Wilkens, LR, Davies, M, Liu, Y, Barnett, MJ, Goodman, GE, Morgenstern, H, Holleczek, B, Thomas, S, Brown, MC, Hung, RJ, Xu, W & Liu, G 2021, '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', Lung Cancer, vol. 152, pp. 58-65. https://doi.org/10.1016/j.lungcan.2020.11.029

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title = "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",

abstract = "Introduction: The 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). Methods: Data 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. Results: Among 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<0.001) and obese categories (pinteraction = 0.004) relative to the normal-BMI category, when compared to male ever-smokers. Conclusion: Underweight and obese female ever-smokers were associated with worse outcomes in White-patients. These BMI associations were not observed in Asian-patients and never-smokers. Black-patients had more favorable outcomes in the extremes of BMI when compared to White-patients. Body composition in Black-patients, and NSCLC subtypes more commonly seen in Asian-patients and never-smokers, may account for differences in these BMI-OS relationships.",

keywords = "Body mass index, Interaction, Lung cancer, Obesity",

author = "Mei Jiang and Fares, {Aline F.} and Daniel Shepshelovich 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 Sanjay Shete 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 Sera Thomas and Brown, {M. Catherine} and Hung, {Rayjean J.} and Wei Xu and Geoffrey Liu",

note = "Publisher Copyright: {\textcopyright} 2020",

year = "2021",

month = feb,

doi = "10.1016/j.lungcan.2020.11.029",

language = "English (US)",

volume = "152",

pages = "58--65",

journal = "Lung Cancer",

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T1 - The relationship between body-mass index and overall survival in non-small cell lung cancer by sex, smoking status, and race

T2 - A pooled analysis of 20,937 International lung Cancer consortium (ILCCO) patients

AU - Jiang, Mei

AU - Fares, Aline F.

AU - Shepshelovich, Daniel

AU - Yang, Ping

AU - Christiani, David

AU - Zhang, Jie

AU - Shiraishi, Kouya

AU - Ryan, Brid M.

AU - Chen, Chu

AU - Schwartz, Ann G.

AU - Tardon, Adonina

AU - Shete, Sanjay

AU - Schabath, Matthew B.

AU - Teare, M. Dawn

AU - Le Marchand, Loic

AU - Zhang, Zuo Feng

AU - Field, John K.

AU - Brenner, Hermann

AU - Diao, Nancy

AU - Xie, Juntao

AU - Kohno, Takashi

AU - Harris, Curtis C.

AU - Wenzlaff, Angela S.

AU - Fernandez-Tardon, Guillermo

AU - Ye, Yuanqing

AU - Taylor, Fiona

AU - Wilkens, Lynne R.

AU - Davies, Michael

AU - Liu, Yi

AU - Barnett, Matt J.

AU - Goodman, Gary E.

AU - Morgenstern, Hal

AU - Holleczek, Bernd

AU - Thomas, Sera

AU - Brown, M. Catherine

AU - Hung, Rayjean J.

AU - Xu, Wei

AU - Liu, Geoffrey

PY - 2021/2

Y1 - 2021/2

N2 - Introduction: The 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). Methods: Data 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. Results: Among 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<0.001) and obese categories (pinteraction = 0.004) relative to the normal-BMI category, when compared to male ever-smokers. Conclusion: Underweight and obese female ever-smokers were associated with worse outcomes in White-patients. These BMI associations were not observed in Asian-patients and never-smokers. Black-patients had more favorable outcomes in the extremes of BMI when compared to White-patients. Body composition in Black-patients, and NSCLC subtypes more commonly seen in Asian-patients and never-smokers, may account for differences in these BMI-OS relationships.

AB - Introduction: The 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). Methods: Data 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. Results: Among 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<0.001) and obese categories (pinteraction = 0.004) relative to the normal-BMI category, when compared to male ever-smokers. Conclusion: Underweight and obese female ever-smokers were associated with worse outcomes in White-patients. These BMI associations were not observed in Asian-patients and never-smokers. Black-patients had more favorable outcomes in the extremes of BMI when compared to White-patients. Body composition in Black-patients, and NSCLC subtypes more commonly seen in Asian-patients and never-smokers, may account for differences in these BMI-OS relationships.

KW - Body mass index

KW - Interaction

KW - Lung cancer

KW - Obesity

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SN - 0169-5002

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JO - Lung Cancer

JF - Lung Cancer

ER -

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

Abstract

Keywords

ASJC Scopus subject areas

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