Obesity as an independent prognostic factor of decreased pathological complete response to neoadjuvant chemotherapy in breast cancer patients.

Karataş, Fatih; Erdem, Gökmen Umut; Şahin, Süleyman; Aytekin, Aydın; Yüce, Deniz; Sever, Ali; Altundağ, Kadri̇

doi:10.1200/jco.2016.34.15_suppl.1029

Cited by 16 publications

(19 citation statements)

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“…Likewise, another study of pancreatic cancer by Duconseil et al, (2019) has reported that obesity is determined as the factor affecting survival. Similarly, Karatas et al, (2017) has reported that obesity is an independent prognostic factor for pCR, with a poor survival in breast cancer patients who received NACT.…”

Section: Discussionmentioning

confidence: 86%

The Effect of Obesity on Response to Neoadjuvant Therapy in Locally Advanced Gastric Cancer

Şahin

Sakin

Aldemir

et al. 2020

Asian Pac J Cancer Prev

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Introduction: The effect of obesity on response to neoadjuvant chemotherapy (NACT) remains unknown. We aimed to investigate the effect of obesity on response to NACT and survival in locally-advanced gastric cancer (GC). Methods: From 2010 to 2019, 142 GC patients with clinical stage III disease who underwent curative surgery after NACT were enrolled. Patients were divided into 3 groups according to body mass index (BMI) as follows; BMI < 25 kg/m 2 , BMI = 25-30 kg/m 2 , and BMI > 30 kg/m 2. The Mandard tumor regression grading system was used for tumor regression grade (TRG). Results: Of the 142 GC patients, 45(31.7%) were female. The median age was 58 years. BMI was < 25 kg/m 2 in 60 (42.3%) patients, 25-30 kg/m2 in 44 (31%) patients, and > 30kg/m 2 in 38 (26.8%) patients. The numbers of patients with TRGI-II, TRGIII, and TRGIV-V were 35 (24.6%), 44 (31%), and 63 (44.4%), respectively. There was no statistically significant difference among BMI groups in terms of disease-free survival (DFS) and overall survival (OS) (p = 0.919 and p = 0.398, respectively). According to TRG groups; mDFS was 46 months in TRG I-II, 28 months in TRG III, and 18 months in TRG IV-V (p<0.001). In multivariate analysis, presence of perineural invasion and lymphovascular invasion were the factors affecting TRG. Conclusion: In our study, we found that pre-treatment obesity did not affect the TRG in clinical stage III GC patients. However, a better TRG status was associated with improved survival.

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Section: Discussionmentioning

confidence: 86%

The Effect of Obesity on Response to Neoadjuvant Therapy in Locally Advanced Gastric Cancer

Şahin

Sakin

Aldemir

et al. 2020

Asian Pac J Cancer Prev

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“…Previous studies assessed the value of obesity in patients treated with NAC. Obesity seems to have a negative impact on survival that is independent from chemotherapy dosing (18)(19)(20)(21).…”

Section: Discussionmentioning

confidence: 99%

Clinical and pathological factors predictive of response to neoadjuvant chemotherapy in breast cancer: A single center experience

et al. 2019

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Neoadjuvant chemotherapy (NAC) of breast cancer (BC) improves outcomes, especially in patients with locally advanced and inflammatory cancer. Further insight into clinic-pathological factors influencing outcomes is essential to define the optimal therapeutic strategy for each category of patients and to predict the response to the treatment. In total, 117 patients with BC were treated with NAC with or without trastuzumab between 2010 and 2015. The histologic response to NAC was defined as a pathological complete response (pCR) when there was no evidence of residual invasive tumor in the breast or axillary lymph nodes. Relapse-free survival (RFS) was estimated using the Kaplan-Meier method and compared using log rank analysis. P-value <0.05 was considered statistically significant. The median age of the 117 patients enrolled in the present study was 52 years (age range, 35-85 years). The overall response rate (complete and partial responses) assessed by radiological and pathological evaluation were 76 and 72%, respectively. pCR was achieved in 35 out of 117 patients (~30%). In total, 6 patients (5%) developed progressive disease during chemotherapy. The RFS was 85 months (SE=3; 95% CI 79-91). The median was not reached and the mean follow-up time was 55 months (median 52 months; range 11-100 months). In this time, 20 patients (17%) experienced tumor recurrence. From the univariate analysis, the pathological response was significantly associated with receptor-based subtype, menopausal status and T-stage. From the multivariate analysis by using linear multiple regression and including receptormenopausal status and T-stage, the model was not significant (P=0.062). However, by using the multiple logistic regression, and including age, pCR was significantly associated with ER+ HER2neg (P=0.006), T2 (P=0.043) and T3 (P=0.018). T-stage, menopausal status and receptor status are significantly associated with the pathological response in patients with inoperable BC treated with NAC.

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“…Among adults, obesity is associated with an increased risk for developing many cancer types (13,14), including esophageal (15), liver (16), gallbladder (17), pancreas (18), breast (19,20), gastric (15), uterine (21), ovarian (21,22), endometrial (23), kidney (24), colorectal cancer (25,26), and meningioma (27,28). Obese adults with breast cancer demonstrate poorer survival (29), and obese children have demonstrated excess chemotherapy toxicity, higher rates of cancer relapse, and lower overall survival compared to patients with normal BMI (29)(30)(31)(32)(33). Several mechanisms, such as hormonal changes, pro-inflammatory states, and chemotherapy sequestration have been proposed to explain how obesity may create a microenvironment that protects the tumor from chemotherapeutic agents and promotes cancer cell growth (34)(35)(36)(37)(38)(39).…”

Section: Introductionmentioning

confidence: 99%

Obesity and Risk for Second Malignant Neoplasms in Childhood Cancer Survivors: A Case–Control Study Utilizing the California Cancer Registry

Moke

Hamilton

Chehab

et al. 2019

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Obesity is a known modifiable risk factor associated with adverse outcomes in children with cancer. We sought to determine if obesity during childhood cancer treatment increases risk for second malignant neoplasms (SMNs). Methods: In this case-control study, cases (with SMN) and controls (with a single primary cancer) were selected from the California Cancer Registry who had primary cancer diagnosed <21 years treated at Children's Hospital Los Angeles (CHLA) between 1988-2014. Controls were matched 3:1 to cases at the registry level by clinical factors. Medical records were abstracted for cancer treatment exposures, cancer predisposition syndrome, body mass index (BMI), BMI Zscore, and BMI category at diagnosis and EOT. Results: Fifty-nine cases and 130 controls were included. Median age at primary cancer diagnosis was 6 years, 64.5% were male, median time from primary cancer to SMN was 7.5 years, and 31.7% were obese or overweight. In matched multivariable analyses, there were elevated but non-significant associations between SMN and higher BMI Z-score at diagnosis (OR 1.27 [0.99-1.63]) and higher BMI categories at diagnosis (adjusted OR [aOR] overweight 1.25 [0.55-2.52]; aOR obese 2.51 [1.00-6.29]). There was a significantly increased risk for SMN among patients who were obese at both diagnosis and EOT (aOR 4.44 [1.37-14.34]). Conclusions: This study suggests obesity during childhood cancer treatment may be associated with increased risk for SMNs, particularly among those obese throughout therapy. Impact: Additional studies to confirm these findings and to develop interventions have the potential to impact SMN development in children with cancer.

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Obesity as an independent prognostic factor of decreased pathological complete response to neoadjuvant chemotherapy in breast cancer patients.

Cited by 16 publications

References 0 publications

The Effect of Obesity on Response to Neoadjuvant Therapy in Locally Advanced Gastric Cancer

The Effect of Obesity on Response to Neoadjuvant Therapy in Locally Advanced Gastric Cancer

Clinical and pathological factors predictive of response to neoadjuvant chemotherapy in breast cancer: A single center experience

Obesity and Risk for Second Malignant Neoplasms in Childhood Cancer Survivors: A Case–Control Study Utilizing the California Cancer Registry

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