Breast Cancer Research and Treatment

, Volume 119, Issue 1, pp 145–153 | Cite as

The effect of body mass index on overall and disease-free survival in node-positive breast cancer patients treated with docetaxel and doxorubicin-containing adjuvant chemotherapy: the experience of the BIG 02-98 trial

  • Evandro de Azambuja
  • Worta McCaskill-Stevens
  • Prudence Francis
  • Emmanuel Quinaux
  • John P. A. Crown
  • Malou Vicente
  • Rosa Giuliani
  • Bo Nordenskjöld
  • Jorge Gutiérez
  • Michael Andersson
  • Mireia Margeli Vila
  • Raimund Jakesz
  • Jan Demol
  • Joanna Dewar
  • Armando Santoro
  • Ana Lluch
  • Steven Olsen
  • Richard D. Gelber
  • Angelo Di Leo
  • Martine Piccart-Gebhart
Clinical trial

Abstract

Background: Obesity has been shown to be an indicator of poor prognosis for patients with primary breast cancer (BC) regardless of the use of adjuvant systemic therapy. Patients and methods: This is a retrospective analysis of 2,887 node-positive BC patients enrolled in the BIG 02-98 adjuvant study, a randomised phase III trial whose primary objective was to evaluate disease-free survival (DFS) by adding docetaxel to doxorubicin-based chemotherapy. In the current analysis, the effect of body mass index (BMI) on DFS and overall survival (OS) was assessed. BMI was obtained before the first cycle of chemotherapy. Obesity was defined as a BMI ≥ 30 kg/m². Results: In total, 547 (19%) patients were obese at baseline, while 2,340 (81%) patients were non-obese. Estimated 5-year OS was 87.5% for non-obese and 82.9% for obese patients (HR 1.34; P = 0.013). Estimated 5-years DFS was 75.9% for non-obese and 70.0% for obese patients (HR 1.20; P = 0.041). In a multivariate model, obesity remained an independent prognostic factor for OS and DFS. Conclusions: In this study, obesity was associated with poorer outcome in node-positive BC patients. Given the increasing prevalence of obesity worldwide, more research on improving the treatment of obese BC patients is needed.

Keywords

Breast cancer Obesity BMI Adjuvant chemotherapy Docetaxel Node-positive 

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Copyright information

© Springer Science+Business Media, LLC. 2009

Authors and Affiliations

  • Evandro de Azambuja
    • 1
  • Worta McCaskill-Stevens
    • 2
  • Prudence Francis
    • 3
    • 4
    • 5
  • Emmanuel Quinaux
    • 6
  • John P. A. Crown
    • 7
  • Malou Vicente
    • 8
  • Rosa Giuliani
    • 9
  • Bo Nordenskjöld
    • 10
  • Jorge Gutiérez
    • 11
  • Michael Andersson
    • 12
  • Mireia Margeli Vila
    • 13
  • Raimund Jakesz
    • 14
  • Jan Demol
    • 15
  • Joanna Dewar
    • 16
  • Armando Santoro
    • 17
  • Ana Lluch
    • 18
  • Steven Olsen
    • 19
  • Richard D. Gelber
    • 20
  • Angelo Di Leo
    • 21
  • Martine Piccart-Gebhart
    • 1
  1. 1.Institut Jules Bordet and Université Libre de Bruxelles (U.L.B)BrusselsBelgium
  2. 2.National Cancer Institute, National Institutes of HealthBethesdaUSA
  3. 3.Peter MacCallum Cancer Centre and St Vincent’s Hospital, Australian New Zealand Breast Cancer Trials GroupMelbourneAustralia
  4. 4.Australian New Zealand Breast Cancer Trials GroupNewcastleAustralia
  5. 5.International Breast Cancer Study GroupBernSwitzerland
  6. 6.International Drug Development InstituteLouvain-La-NeuveBelgium
  7. 7.St. Vincent’s HospitalDublinIreland
  8. 8.Br.E.A.S.T. Data CentreBrusselsBelgium
  9. 9.Medical Oncology UnitS. Camillo-Forlanini HospitalRomeItaly
  10. 10.Universitetssjukhuset, OncologyLinköpingSweden
  11. 11.Clinica Las CondesLas Condes, SantiagoChile
  12. 12.Department of Oncology, The Finsen CentreCopenhagen University HospitalRigshospitaletDenmark
  13. 13.Hospital Germans Trias I PujolBadalonaSpain
  14. 14.University of Vienna, General HospitalViennaAustria
  15. 15.Heilig Hart ZiekenhuisRoeselareBelgium
  16. 16.Sir Charles Gairdner HospitalNedlandsWestern Australia
  17. 17.Istituto Clinico HumanitasRozzanoItaly
  18. 18.Hospital Clinico UniversitarioValenciaSpain
  19. 19.Sanofi-aventisParisFrance
  20. 20.Department of Biostatistics and Computational BiologyDana-Farber Cancer InstituteBostonUSA
  21. 21.Sandro Pitigliani Medical Oncology UnitHospital of PratoPratoItaly

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