Prognostic value of preoperative weight loss-adjusted body mass index on survival after esophagectomy for esophageal squamous cell carcinoma

BACKGROUND The impact of body mass index(BMI)on survival in patients with esophageal squamous cell carcinoma(ESCC)undergoing surgery remains unclear.Therefore,a definition of clinically significant BMI in patients with ESCC is needed.AIM To explore the impact of preoperative weight loss(PWL)-adjusted BMI on overall survival(OS)in patients undergoing surgery for ESCC.METHODS This retrospective study consisted of 1545 patients who underwent curative resection for ESCC at West China Hospital of Sichuan University between August 2005 and December 2011.The relationship between PWL-adjusted BMI and OS was examined,and a multivariate analysis was performed and adjusted for age,sex,TNM stage and adjuvant therapy.RESULTS Trends of poor survival were observed for patients with increasing PWL and decreasing BMI.Patients with BMI≥20.0 kg/m2 and PWL<8.8%were classified into Group 1 with the longest median OS(45.3 mo).Patients with BMI<20.0 kg/m2 and PWL<8.8%were classified into Group 2 with a median OS of 29.5 mo.Patients with BMI≥20.0 kg/m2 and PWL≥8.8%(HR=1.9,95%CI:1.5-2.5),were combined into Group 3 with a median OS of 20.1 mo.Patients in the three groups were associated with significantly different OS(P<0.05).In multivariate analysis,PWL-adjusted BMI,TNM stage and adjuvant therapy were identified as independent prognostic factors.CONCLUSION PWL-adjusted BMI has an independent prognostic impact on OS in patients with ESCC undergoing surgery.BMI might be an indicator for patients with PWL<8.8%rather than≥8.8%.

Weight change and all-cause and cause-specific mortality:A 25-year follow-up study

Background:Whether the dynamic weight change is an independent risk factor for mortality remains controversial.This study aimed to examine the association between weight change and risk of all-cause and cause-specific mortality based on the Linxian Nutrition Intervention Trial(NIT)cohort.Methods:Body weight of 21,028 healthy residents of Linxian,Henan province,aged 40-69 years was measured two times from 1986 to 1991.Outcome events were prospectively collected up to 2016.Weight maintenance group(weight change<2 kg)or stable normal weight group was treated as the reference.Cox proportional hazard model was performed to calculate hazard ratios(HRs)and 95%confidence intervals(95%CIs)to estimate the risk of mortality.Results:A total of 21,028 subjects were included in the final analysis.Compared with the weight maintenance group,subjects with weight loss≥2 kg had an increased risk of death from all-cause(HR_(All-cause)=1.14,95%CI:1.09-1.19,P<0.001),cancer(HR_(Cancer)=1.12,95%CI:1.03-1.21,P=0.009),and heart disease(HR_(Heart diseases)=1.21,95%CI:1.11-1.31,P<0.001),whereas subjects with weight gain≥5 kg had 11%(HR_(Cancer)=0.89,95%CI:0.79-0.99,P=0.033)lower risk of cancer mortality and 23%higher risk of stroke mortality(HR_(Stroke)=1.23,95%CI:1.12-1.34,P<0.001).For the change of weight status,both going from overweight to normal weight and becoming underweight within 5 years could increase the risk of total death(HR_(Overweight to normal)=1.18,95%CI:1.09-1.27;HR_(Becoming underweight)=1.35,95%CI:1.25-1.46)and cancer death(HR_(Overweight to normal)=1.20,95%CI:1.04-1.39;HR_(Becoming underweight)=1.44,95%CI:1.24-1.67),while stable overweight could increase the risk of total death(HR_(Stable overweight)=1.11,95%CI:1.05-1.17)and death from stroke(HR_(Stable overweight)=1.44,95%CI:1.33-1.56).Interaction effects were observed between age and weight change on cancer mortality,as well as between baseline BMI and weight change on all-cause,heart disease,and stroke mortality(all P_(interaction)<0.01).Conclusions:Weight loss was associated with an increased risk of all-cause,cancer,and heart disease mortality,whereas excessive weight gain and stable overweight were associated with a higher risk of stroke mortality.Efforts of weight management should be taken to improve health status.Trial registration:https://classic.clinicaltrials.gov/,NCT00342654.

Monthly gravity field recovery from GRACE orbits and K-band measurements using variational equations approach

The Gravity Recovery and Climate Experiment（GRACE） mission can significantly improve our knowledge of the temporal variability of the Earth＇s gravity field.We obtained monthly gravity field solutions based on variational equations approach from GPS-derived positions of GRACE satellites and K-band range-rate measurements.The impact of different fixed data weighting ratios in temporal gravity field recovery while combining the two types of data was investigated for the purpose of deriving the best combined solution.The monthly gravity field solution obtained through above procedures was named as the Institute of Geodesy and Geophysics（IGG） temporal gravity field models.IGG temporal gravity field models were compared with GRACE Release05（RL05） products in following aspects：（i） the trend of the mass anomaly in China and its nearby regions within 2005-2010; （ii） the root mean squares of the global mass anomaly during 2005-2010; （iii） time-series changes in the mean water storage in the region of the Amazon Basin and the Sahara Desert between 2005 and 2010.The results showed that IGG solutions were almost consistent with GRACE RL05 products in above aspects（i）-（iii）.Changes in the annual amplitude of mean water storage in the Amazon Basin were 14.7 ± 1.2 cm for IGG,17.1 ± 1.3 cm for the Centre for Space Research（CSR）,16.4 ± 0.9 cm for the GeoForschungsZentrum（GFZ） and 16.9 ± 1.2 cm for the Jet Propulsion Laboratory（JPL） in terms of equivalent water height（EWH）,respectively.The root mean squares of the mean mass anomaly in Sahara were 1.2 cm,0.9 cm,0.9 cm and 1.2 cm for temporal gravity field models of IGG,CSR,GFZ and JPL,respectively.Comparison suggested that IGG temporal gravity field solutions were at the same accuracy level with the latest temporal gravity field solutions published by CSR,GFZ and JPL.

Impact of body mass index,weight gain,and metabolic disorders on survival and prognosis in patients with breast cancer who underwent chemotherapy

Background: Weight gain during chemotherapy in patients with breast cancer contributes to their poor prognosis. However, a growing number of studies have found that metabolic disorders seem to play a more important role in breast cancer prognosis than weight gain. This study aimed to explore the prognostic effects of body mass index (BMI), weight gain, and metabolic disorders on the overall survival (OS) and prognosis of patients with breast cancer who underwent chemotherapy.Methods: Data from the inpatient medical records of patients with breast cancer who underwent chemotherapy at the Beijing Cancer Hospital Breast Cancer Center from January to December 2010 were retrospectively collected, and the patients were followed up until August 2020.Results: A total of 438 patients with stages I to III breast cancer met the inclusion and exclusion criteria. Forty-nine (11.19%) patients died, while 82 (18.72%) patients had tumor recurrence and metastasis at the last follow-up (August 2020). From the time of diagnosis until after chemotherapy, no significant differences were observed in the body weight (t=4.694,P<0.001), BMI categories (χ^(2)=19.215,P=0.001), and incidence of metabolic disorders (χ^(2)=24.841,P<0.001);the BMI categories and weight change had no effect on the OS. Both univariate (χ^(2)=6.771,P=0.009) and multivariate survival analyses (hazard ratio=2.775, 95% confidence interval [CI]: 1.326-5.807,P=0.007) showed that low high-density lipoprotein cholesterol (HDL-C) levels at diagnosis had a negative impact on the OS. The multivariate logistic regression analysis showed that the HDL-C level at diagnosis (odds ratio [OR]=2.200, 95% CI: 0.996-4.859,P=0.051) and metabolic disorders after chemotherapy (OR=1.514, 95% CI: 1.047-2.189,P=0.028) are risk factors for poor prognosis in patients with breast cancer.Conclusions: Chemotherapy led to weight gain and aggravated the metabolic disorders in patients with breast cancer. Low HDL-C levels at diagnosis and metabolic disorders after chemotherapy may have negative effects on the OS and prognosis of patients with breast cancer.

A remote,fully oriented personalized program of physical exercise for women in follow-up after breast cancer treatment improves body composition and physical fitness

This study aimed to evaluate the efficacy of an individualized remote exercise program on the improvement of body composition and physical fitness of a heterogeneous group of patients who completed breast cancer treatment.This prospective study included 107 women aged 18 to 60,shortly after curative treatment for localized breast cancer,at the Erasto Gaertner Cancer Hospital(HEG)in Curitiba,PR,Brazil.Body composition,maximal oxygen consumption,and muscle resistance were evaluated after nine months of intervention while considering adherence to the program,level of physical activity,presence of binge eating disorder,tumor classification,and treatment type.Seventy-eight women(72.8%)adhered to the training program.Adherent participants showed significant changes in body mass([-4.3±3.6]kg;p<0.0001),body mass index([-1.6±1.5]kg·m^(−2);p<0.0001),body fat(−3.4%±3.1%;p<0.0001),maximal oxygen consumption([7.5±2.0]ml·kg^(−1)·min^(−1));p<0.0001),and abdominal resistance([11.2±2.8]reps;p<0.0001).In contrast,these variables did not change significantly in the non-adherent group.Among the adherent participants,those subclassified in the severe binge group showed a more noticeable reduction in body mass,body mass index,and body fat(p<0.05)than those in the non-binge group.Individualized remotely-guided physical exercise programs can improve the body composition and physical fitness of women undergoing post-breast cancer surveillance,regardless of pathological history or treatment.