Body mass index as an independent prognostic factor in glioblastoma

Aguiar, Pedro Valente; Carvalho, Bruno; Vaz, Rui; Linhares, Paulo

doi:10.1007/s10552-020-01388-9

Cited by 8 publications

(7 citation statements)

References 37 publications

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“…However, the pooled analysis of ve studies demonstrated the decreased OS in patients with lower BMI compared with patients with obesity [35]. Consequently, the prognostic value of BMI in patients with GBM was proposed in several studies [12][13][14]. The unavailable of MGMT promoter methylation status may be a limitation for these studies, which can affect the sensitivity of patients for temozolomide chemotherapy and the OS of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Obesity population, de ned by BMI, has been associated with better prognoses of cancer patients undergoing surgery, including rectal cancer, non-small-cell lung cancer, intra-abdominal cancer, hepatocellular carcinoma and pancreatic cancer, which is described as "obesity paradox" [11]. Elevated BMI may be associated with better survival in patients with newly diagnosed GBM [12][13][14]. However, a large prospective multicenter study proposed that no relationship between BMI and survival in newly diagnosed and previously untreated patients with GBM has been found [15].…”

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confidence: 99%

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Association of body mass index with clinical outcome of WHO grade 4 glioma

Wang

Hao

et al. 2023

Preprint

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Purpose The prognostic value of body mass index (BMI) in WHO grade 4 gliomas is not well acknowledged. This study aimed to assess the survival outcomes of patients with different BMI. Methods Real-world data of patients diagnosed of WHO grade 4 (2021 version) glioma was assessed in a prospective design. All patients have undergone standard-of-care, from September 2018 to September 2021. Outcomes of overall survival and progression-free survival were analyzed. Results 127 patients were ultimately admitted in this study. Baseline characteristics of clinical features, molecular features, and secondary treatment in BMI subsets showed no significant difference. Survival analyses showed a significantly superior OS in overweight group comparing to normal weight group. A trend of favoring a better OS of overweight group comparing to obesity group has been observed. Univariate cox regression demonstrated patients of round-BMI 25 and 26 obtained superior OS outcomes under standard-of-care of WHO grade 4 gliomas. Conclusion In this real-world setting, overall survival was shown to be improved in patients with overweight. Patients in proper BMI range may acquire survival benefit undergoing standard-of-care of WHO grade 4 gliomas. Large scale studies on these subsets of patients are needed.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Association of body mass index with clinical outcome of WHO grade 4 glioma

Wang

Hao

et al. 2023

Preprint

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“…However, studies that reported no or even a favorable association of obesity with OS had aspects that make it difficult to compare their results to the findings of the GLARIUS and CeTeG/NOA-09 trial cohort reported here: Jones et al included patients from 1991 to 2008 who mostly did not receive first-line chemotherapy [ 7 ], and three other studies mostly included patients with inferior prognostic factors such as low KPS and/or low complete resection rates [ 3 , 5 , 8 ]. One study that found a positive correlation of obesity and OS is difficult to interpret since obese and non-obese patients were imbalanced regarding percentage of complete resections (68.8% vs. 55.2%) and female patients (66% vs. 35%) [ 6 ]. Female sex may be a favorable prognostic factor that was not included in univariate and multivariate analyses [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

“…Prognostic factors including age, Karnofsky performance scale (KPS), extent of resection, and MGMT promoter methylation status, aid to estimate the course of disease and enable shared decision-making regarding therapeutic options [ 2 ]. The impact of obesity on survival in high grade glioma has been retrospectively analyzed with contradicting results, as it was associated with better [ 3 – 6 ], indifferent [ 7 ], or worse survival [ 8 , 9 ]. Notably, these studies exhibit limitations, including recruitment before current standard therapies [ 7 ], inclusion of different tumor grades [ 8 , 9 ], the single- or bicentric retrospective nature of analyses [ 3 – 8 ], and not accounting for MGMT promoter methylation status.…”

Section: Introductionmentioning

confidence: 99%

Prognostic impact of obesity in newly-diagnosed glioblastoma: a secondary analysis of CeTeG/NOA-09 and GLARIUS

et al. 2022

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Purpose The role of obesity in glioblastoma remains unclear, as previous analyses have reported contradicting results. Here, we evaluate the prognostic impact of obesity in two trial populations; CeTeG/NOA-09 (n = 129) for MGMT methylated glioblastoma patients comparing temozolomide (TMZ) to lomustine/TMZ, and GLARIUS (n = 170) for MGMT unmethylated glioblastoma patients comparing TMZ to bevacizumab/irinotecan, both in addition to surgery and radiotherapy. Methods The impact of obesity (BMI ≥ 30 kg/m2) on overall survival (OS) and progression-free survival (PFS) was investigated with Kaplan–Meier analysis and log-rank tests. A multivariable Cox regression analysis was performed including known prognostic factors as covariables. Results Overall, 22.6% of patients (67 of 297) were obese. Obesity was associated with shorter survival in patients with MGMT methylated glioblastoma (median OS 22.9 (95% CI 17.7–30.8) vs. 43.2 (32.5–54.4) months for obese and non-obese patients respectively, p = 0.001), but not in MGMT unmethylated glioblastoma (median OS 17.1 (15.8–18.9) vs 17.6 (14.7–20.8) months, p = 0.26). The prognostic impact of obesity in MGMT methylated glioblastoma was confirmed in a multivariable Cox regression (adjusted odds ratio: 2.57 (95% CI 1.53–4.31), p < 0.001) adjusted for age, sex, extent of resection, baseline steroids, Karnofsky performance score, and treatment arm. Conclusion Obesity was associated with shorter survival in MGMT methylated, but not in MGMT unmethylated glioblastoma patients.

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“…The obese population, defined by BMI, has been associated with better prognoses of cancer patients undergoing surgery, including rectal cancer, non-small-cell lung cancer, intra-abdominal cancer, hepatocellular carcinoma, and pancreatic cancer, and this is called the “obesity paradox” ( 11 ). The elevated BMI may be associated with better survival in patients with newly diagnosed GBM ( 12 – 14 ). However, a large prospective multicenter study found no relationship between BMI and survival in newly diagnosed and previously untreated GBM patients ( 15 ).…”

Section: Introductionmentioning

confidence: 99%

Association of body mass index with clinical outcome of primary WHO grade 4 glioma

Wang,

Hao,

et al. 2024

Front. Oncol.

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BackgroundThe prognostic value of body mass index (BMI) in primary WHO grade 4 gliomas is not widely acknowledged. This study aims to assess the survival outcomes of patients with different BMIs.MethodsReal-world data of patients diagnosed with primary WHO grade 4 (2021 version) glioma was assessed. All 127 patients admitted in this study were administered with standard-of-care from September 2018 to September 2021. The outcomes of overall survival and progression-free survival were analyzed.ResultsThe baseline characteristics of clinical features, molecular features, and secondary treatment in BMI subsets showed no significant difference. The survival analyses showed a significantly superior overall survival (OS) in the overweight group compared to the normal weight group. A trend of better OS in the overweight group compared to the obesity group was observed. The univariate Cox regression demonstrated patients of round-BMI 25 and 26 had superior OS outcomes.ConclusionIn this real-world setting, patients with a BMI between 24 and 28 have superior overall survival. Patients in the proper BMI range may acquire survival benefits undergoing standard-of-care of primary WHO grade 4 gliomas. The prospective studies on a larger scale on these subsets of patients are necessary to solve the paradox of BMI in glioma.

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Body mass index as an independent prognostic factor in glioblastoma

Cited by 8 publications

References 37 publications

Association of body mass index with clinical outcome of WHO grade 4 glioma

Association of body mass index with clinical outcome of WHO grade 4 glioma

Prognostic impact of obesity in newly-diagnosed glioblastoma: a secondary analysis of CeTeG/NOA-09 and GLARIUS

Association of body mass index with clinical outcome of primary WHO grade 4 glioma

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