Journal of Neuro-Oncology

, Volume 114, Issue 1, pp 79–84

Prediagnostic body weight and survival in high grade glioma

  • Erin M. Siegel
  • L. Burton Nabors
  • Reid C. Thompson
  • Jeffrey J. Olson
  • James E. Browning
  • Melissa H. Madden
  • Gang Han
  • Kathleen M. Egan
Clinical Study

Abstract

Greater adiposity has been linked to an increased risk and/or poorer survival in a variety of cancers. We examined whether prediagnostic body weight 1–5 years prior to diagnosis is associated with survival in patients with high grade glioma. The analysis was based on a series of patients with high-grade glioma (N = 853) enrolled in a US-based multicenter case–control study. Subjects reported height and weight 1–5 years prior to interview and at age 21. BMI was categorized according to WHO criteria as underweight (BMI <18.5 kg/m2), normal weight (BMI 18.5–24.9 kg/m2), overweight (BMI 25–29.9 kg/m2) and obese (BMI ≥30 kg/m2). Proportional hazards regression was used to estimate hazard ratios (HR) and 95 % confidence intervals (CIs) for glioma-related death according to body mass index (BMI, kg/m2). Overall survival was reduced among patients underweight (median survival: 12.0 months) or obese (median: 13.6 months) when compared to patients of normal weight (median: 17.5 months) prior to glioma diagnosis (p = 0.004). In a multivariate model controlling for other prognostic factors, an excess mortality was observed in patients reporting obese body weights 1–5 years prior to study interview when compared to patients with a normal BMI (HR = 1.32; 95 % CI 1.04–1.68). Consistent patterns of association with excess body weight were observed in men and women, and all findings were similar regardless of treatment for glioma. A lower than optimal body weight was associated with a nonsignificant excess mortality in multivariate analysis. Premorbid obesity was significantly associated with a poor patient outcome independent of treatment and established prognostic factors. Excess body weight may be an adverse prognostic factor in glioma, a relationship observed across a spectrum of cancer types. The current findings linking prediagnostic body weight with mortality in high-grade glioma warrant further research.

Keywords

Glioma Glioblastoma BMI Survival prediagnostic body weight 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Erin M. Siegel
    • 1
  • L. Burton Nabors
    • 2
  • Reid C. Thompson
    • 3
  • Jeffrey J. Olson
    • 4
  • James E. Browning
    • 1
  • Melissa H. Madden
    • 1
  • Gang Han
    • 5
  • Kathleen M. Egan
    • 1
  1. 1.Department of Cancer EpidemiologyH. Lee Moffitt Cancer Center and Research InstituteTampaUSA
  2. 2.Neuro-oncology ProgramUniversity of Alabama at BirminghamBirminghamUSA
  3. 3.Department of Neurological SurgeryVanderbilt University Medical CenterNashvilleUSA
  4. 4.Department of NeurosurgeryEmory University School of MedicineAtlantaUSA
  5. 5.Department of BiostatisticsH. Lee Moffitt Cancer Center and Research InstituteTampaUSA

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