Efect of body mass index on survival of patients with stage I non-small cell lung cancer

Background:Body mass index(BMI)has a U?shaped association with lung cancer risk.However,the effect of BMI on prognosis is controversial.This retrospective study aimed to investigate the effect of BMI on the survival of patients with stage I non?small cell lung cancer(NSCLC)after surgical resection.Methods:In total,624 consecutive stage I NSCLC patients who underwent radical resection were classified into four groups according to their BMI:underweight(BMI<18.5 kg/m^2),normal weight(BMI obese(BMI>28.0 kg/m^2).The effect of BMI on progress=18.5–22.4 kg/m2),overweight(BMI=22.5–28.0 kg/m^2),andion?free survival(PFS)and over?all survival(OS)was estimated using the Kaplan–Meier method and Cox proportional hazards model.Postoperative complications in each group were analyzed using the Chi square test or Fisher’s exact test.Results:A univariate analysis showed that PFS and OS were longer in the overweight group than in other groups(both P<0.05).A multivariate analysis showed that OS was longer in the overweight group than in other groups(compared with the other three groups in combination:hazard ratio[HR]e underweight group:HR=1.87,95%confidence interval[CI]1.30–2.68,P=0.003;compared with th3,P=2.24,95%CI 1.18–4.25,P=0.013;compared with the normal weight group:HR 1.48–5.59,P=1.58,95%CI 1.07–2.3=0.022;compared with the obese group:HR=2.87,95%CIwe=0.002),but PFS was similar among the groups(HRd an association between being overweight and pro=1.28,95%CI 0.97–1.68,P longed OS in patients at sta=0.080).A subgroup analysis shoge T1a(P 0.001).Overweight=0.024),T1b(P=0.051),and T2a(P=0.02),as well as in patients with a non?smoking history(P=patients had lower rates of postoperative complications,such as respiratory failure(compared with the underweight and obese groups:P=0.014),myocardial infarction(compared with the obese group:P=0.033),and perioperative death(com?pared with the other three groups:P=0.016).Conclusions:Preoperative BMI is an independent prognostic factor for stage I NSCLC patients after resection,with overweight patients having a favorable prognosis.

体质指数对Ⅰ期非小细胞肺癌患者预后的影响

背景与目的体质指数(body mass index, BMI)与肺癌的发生存在U?型相关性,但其对肺癌预后的影响仍存有争议。本研究回顾分析BMI对I期非小细胞肺癌(non?small cell lung cancer, NSCLC)患者手术预后的影响。方法将624例行根治性切除术的I期NSCLC患者按BMI分为四组:低体质量(BMI <18.5 kg/m2)、正常(BMI=18.5–22.4 kg/m2)、超重(BMI=22.5–28.0 kg/m2)和肥胖(BMI> 28 kg/m2)。采用Kaplan?Meier法和Cox比例风险模型分析BM I对无进展生存期(progression?freesur v ival,PFS)和总生存期(overall sur vival,OS)的影响。采用χ2检验或精确概率Fisher检验分析BMI与术后并发症的相关性。结果单因素分析结果显示,超重组的PFS和OS均比其他组长(P <0.05)。多因素分析结果显示,超重组的OS比其他组长(与其他三组联合相比:HR=1.87, 95%CI:1.30–2.68, P=0.003;与低体质量组相比:HR=2.24, 95%CI:1.18–4.25, P=0.013;与正常组相比:HR=1.58, 95%CI:1.07–2.33, P=0.022;与肥胖组相比:HR=2.87, 95%CI:1.48–5.59,P=0.002),但各组间的PFS相似(HR=1.28, 95%CI:0.97–1.68, P=0.080)。亚组分析表明,超重与T1a(P=0.024)、T1b (P=0.051)、T2a(P=0.02)期和非吸烟(P=0.001)患者的OS延长相关。超重患者术后并发症:呼吸衰竭(与低体质量和肥胖组相比:P=0.014)、心肌梗死(与肥胖组相比:P=0.033)、围手术期死亡(与其他三组相比:P=0.016)的发生率较低。结论术前BMI是I期非小细胞肺癌患者手术预后的独立影响因素,超重患者预后较好。