Impact of body mass index on overall survival in patients with metastatic breast cancer.
BACKGROUND
High Body mass index (BMI) is a risk factor for breast cancer among postmenopausal women and an adverse prognostic factor in early-stage. Little is known about its impact on clinical outcomes in patients with metastatic breast cancer (MBC).


METHODS
The National ESME-MBC observational cohort includes all consecutive patients newly diagnosed with MBC between Jan 2008 and Dec 2016 in the 18 French comprehensive cancer centers.


RESULTS
Of 22 463 patients in ESME-MBC, 12 999 women had BMI data available at MBC diagnosis. Median BMI was 24.9 kg/m2 (range 12.1-66.5); 20% of women were obese and 5% underweight. Obesity was associated with more de novo MBC, while underweight patients had more aggressive cancer features. Median overall survival (OS) of the BMI cohort was 47.4 months (95% CI [46.2-48.5]) (median follow-up: 48.6 months). Underweight was independently associated with a worse OS (median OS 33 months; HR 1.14, 95%CI, 1.02-1.27) and first line progression-free survival (HR, 1.11; 95%CI, 1.01; 1.22), while overweight or obesity had no effect.


CONCLUSION
Overweight and obesity are not associated with poorer outcomes in women with metastatic disease, while underweight appears as an independent adverse prognostic factor.
['Saleh|Khalil|K|', 'Carton|Matthieu|M|', 'Dieras|Véronique|V|', 'Heudel|Pierre-Etienne|PE|', 'Brain|Etienne|E|', "D'Hondt|Véronique|V|", 'Mailliez|Audrey|A|', 'Patsouris|Anne|A|', 'Mouret-Reynier|Marie-Ange|MA|', 'Goncalves|Anthony|A|', 'Ferrero|Jean Marc|JM|', 'Petit|Thierry|T|', 'Emile|George|G|', 'Uwer|Lionel|L|', 'Debled|Marc|M|', 'Dalenc|Florence|F|', 'Jouannaud|Christelle|C|', 'Ladoire|Sylvain|S|', 'Leheurteur|Marianne|M|', 'Cottu|Paul|P|', 'Veron|Lucie|L|', 'Savignoni|Alexia|A|', 'Courtinard|Coralie|C|', 'Robain|Mathieu|M|', 'Delaloge|Suzette|S|', 'Deluche|Elise|E|']
D015992:Body Mass Index D001943:Breast Neoplasms D005260:Female D006801:Humans D009765:Obesity D050177:Overweight D011379:Prognosis D012189:Retrospective Studies D012307:Risk Factors
Overall survival Metastatic breast cancer BMI Obesity Underweight