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Prediagnostic body weight and survival in high grade glioma

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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.

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Acknowledgments

The authors wish to acknowledge the study participants and their families. We further wish to thank the clinicians and research staffs at participating medical centers for their contributions. In addition, we acknowledge Dr. Renato V. LaRocca at the Kentuckianna Cancer Institute in Louisville, KY and Dr. Sajeel A. Chowdhary at Florida Hospital Cancer Institute in Orlando, FL, as well as Harold Colbassani, MD; Dean Gobo, MD; and Christopher Mickler, DO at Morton Plant Mease Healthcare and Baycare Health System in Clearwater, FL for their efforts recruiting subjects to the study. The project was supported by the National Institutes of Health (5R01CA116174) and institutional funding provided by the Moffitt Cancer Center (Tampa, FL) and the Vanderbilt-Ingram Comprehensive Cancer Center (Nashville, TN).

Conflict of interest

The authors declare they have no conflicts of interest.

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Authors and Affiliations

  1. Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, MRC-CANCONT, Tampa, FL, 33612-9416, USA

    Erin M. Siegel, James E. Browning, Melissa H. Madden & Kathleen M. Egan

  2. Neuro-oncology Program, University of Alabama at Birmingham, FOT 1020, 510 20th St. South, Birmingham, AL, 35294, USA

    L. Burton Nabors

  3. Department of Neurological Surgery, Vanderbilt University Medical Center, 691 Preston Building, Nashville, TN, 37232, USA

    Reid C. Thompson

  4. Department of Neurosurgery, Emory University School of Medicine, 1365-B Clifton Rd., NE, Ste. 2200, Atlanta, GA, 30322, USA

    Jeffrey J. Olson

  5. Department of Biostatistics, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL, 33612, USA

    Gang Han

Authors
  1. Erin M. Siegel
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  2. L. Burton Nabors
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  3. Reid C. Thompson
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  4. Jeffrey J. Olson
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  5. James E. Browning
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  6. Melissa H. Madden
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  7. Gang Han
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  8. Kathleen M. Egan
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Correspondence to Kathleen M. Egan.

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Siegel, E.M., Nabors, L.B., Thompson, R.C. et al. Prediagnostic body weight and survival in high grade glioma. J Neurooncol 114, 79–84 (2013). https://doi.org/10.1007/s11060-013-1150-2

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  • DOI: https://doi.org/10.1007/s11060-013-1150-2

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