Prediagnosis weight loss, a stronger factor than BMI, to predict survival in patients with lung cancer

Morel, Hugues; Raynard, Bruno; D'Arlhac, M.; Hauss, Pierre-Alexandre; Lecuyer, E.; Oliviéro, G.; Marty, Clothilde; Gury, Jean-Pierre; Asselain, Bernard; Grivaux, M; Debieuvre, D.

doi:10.1016/j.lungcan.2018.07.005

Cited by 39 publications

(37 citation statements)

References 20 publications

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“…The median pre-disease BMI recorded in current series (24.9 kg/m 2 ) was identical to the median BMI of French general population. Our percent of underweight (<10%), normal weight (50%), and overweight-obese patients (around 40%) were also almost identical to those recorded in a Canadian report [25], as well as in a large French cohort of 6595 patients diagnosed with NSCLC in several non-academic centers [26].…”

Section: Discussionsupporting

confidence: 84%

“…Weight loss is notably related to morbidity/mortality in hospitalized patients, especially if surgically treated [9,16,29]. It is also a predictive factor of shorter survival in patients with advanced inoperable lung cancers [12,26]. Schematically, almost half of our patients (44.4%) showed WL.…”

Section: Lower Bmi Weight Loss and Low Muscle Mass Negatively Impactmentioning

confidence: 81%

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Pre-Disease and Pre-Surgery BMI, Weight Loss and Sarcopenia Impact Survival of Resected Lung Cancer Independently of Tumor Stage

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Schussler

Loi³

et al. 2020

Cancers

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Lower pre-surgery Body Mass Index (BMI) and low muscle mass impact negatively long-term survival of non-small cell lung cancer (NSCLC). We investigated their influence on survival after major lung resection for NSCLC. Methods: A retrospective analysis of a prospectively collected database was made on 304 consecutive patients. Results: Underweight, normal, overweight and obese patients represented 7.6%, 51.6%, 28.6%, and 12.6% of the pre-disease population. Weight loss and gain were recorded in 44.4% and 5% of patients, respectively. Low muscle mass was more frequently associated with BMI < 25 kg/m2 (p < 0.000001). Overall survival was positively affected by pre-disease (p = 0.036) and pre-surgery (p = 0.017) BMI > 25 kg/m2, and, even more, in case of BMI > 25 kg/m2 and increasing weight (p = 0.012). Long-term outcome was negatively influenced by low muscle mass (p = 0.042) and weight loss (p = 0.0052) as well as age (p = 0.017), ASA categories (p = 0.025), extent of resection (p = 0.0001), pleural invasion (p = 0.0012) and higher pathologic stage (p < 0.0001). Three stepwise multivariable models confirmed the independent favorable prognostic value of higher pre-disease (RR 0.66[0.49–0.89], p = 0.006) and pre-surgery BMI (RR 0.72[0.54–0.98], p = 0.034), and the absence of low muscle mass (RR 0.56[0.37–0.87], p = 0.0091). Conclusions: Body reserves assessed by simple clinical markers impact survival of surgically treated NSCLC. Strategies improving body fat and muscular mass before surgery should be considered.

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Section: Discussionsupporting

confidence: 84%

Section: Lower Bmi Weight Loss and Low Muscle Mass Negatively Impactmentioning

confidence: 81%

Pre-Disease and Pre-Surgery BMI, Weight Loss and Sarcopenia Impact Survival of Resected Lung Cancer Independently of Tumor Stage

Icard

Schussler

Loi³

et al. 2020

Cancers

View full text Add to dashboard Cite

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“…Among the clinical nutritional parameters, the BMI was significantly higher among the older patients; however, it is important to investigate other nutritional variables, because even obesity could still be present in patients suffering from malnutrition, protein deficiency, and also sarcopenia [24, 25]. That is why we cannot assume that being overweight sets aside the possibility of nutritional impairment.…”

Section: Discussionmentioning

confidence: 99%

Impact of Age on Inflammation-Based Scores among Patients Diagnosed with Stage III Non-Small Cell Lung Cancer

et al. 2020

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Background: Inflammatory and nutritional indexes are prognostic factors in non-small cell lung cancer (NSCLC). Furthermore, a low grade of chronic inflammation has been described in the older population (inflammaging). We aimed to evaluate the neutrophil-to-lymphocyte ratio (NLR), the Prognostic Nutritional Index (PNI), the advanced lung cancer inflammation index (ALI), the platelet-to-lymphocyte ratio (PLR), and the Glasgow Prognostic Score (GPS) in young and older patients diagnosed with locally advanced NSCLC to determine if significant differences between these groups exist. Methods: We conducted a retrospective study analyzing the impact of age on the NLR, PNI, ALI, PLR, and GPS among patients diagnosed with stage III NSCLC at Hospital Universitario Doctor Peset between 2010 and 2015. Results: We included 124 patients (84 young, 40 older patients). The median hemoglobin level and leukocyte count were lower in the older patients (p = 0.0158 and p = 0.001, respectively). A higher median C-reactive protein level was also found in this group (p = 0.0095). Regarding specific inflammatory indexes, the PNI, comprising inflammatory and nutritional parameters, was lower among the older patients (p = 0.0463). The median NLR, ALI, and PLR were similar in both age groups. Moreover, no differences between the age groups were found in the percentage of patients showing high versus low NLR (cutoff point, 5) or ALI (cutoff point, 18) or in the different GPS groups. Conclusions: The baseline PNI, hemoglobin level, and lymphocyte count were lower among the older patients; furthermore, CRP was higher, possibly, because of a more prominent inflammatory status in older patients with lung cancer. No other immunological or nutritional analytical variables were different between the age groups.

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“…Despite the growing number of studies showing the impacts of anorexia and weight loss on the quality of life and survival of patients with lung cancer, these conditions are underdiagnosed and undertreated in clinical practice because of the scarcity of protocols for diagnosis and effective treatment. 6 , 15 In addition, predictive factors for unintentional weight loss in the period preceding the diagnosis of lung cancer are not well described in the literature, nor is the importance of the role that anorexia and weight loss play in the prognosis of lung cancer in Brazil. Therefore, the objectives of the present study were to determine the prevalence of anorexia and pre-treatment weight loss, to identify the factors associated with unintentional pre-treatment weight loss, and to define the role that anorexia and pre-treatment weight loss play in the overall survival of patients with stage IV lung cancer.…”

Section: Introductionmentioning

confidence: 99%

Role that anorexia and weight loss play in patients with stage IV lung cancer

2020

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Prediagnosis weight loss, a stronger factor than BMI, to predict survival in patients with lung cancer

Cited by 39 publications

References 20 publications

Pre-Disease and Pre-Surgery BMI, Weight Loss and Sarcopenia Impact Survival of Resected Lung Cancer Independently of Tumor Stage

Pre-Disease and Pre-Surgery BMI, Weight Loss and Sarcopenia Impact Survival of Resected Lung Cancer Independently of Tumor Stage

Impact of Age on Inflammation-Based Scores among Patients Diagnosed with Stage III Non-Small Cell Lung Cancer

Role that anorexia and weight loss play in patients with stage IV lung cancer

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