Prognostic Value of Body Mass Index in Stage II/III Colon Cancer: Posthoc Analysis From the TOSCA Trial.

Debora Basile, Gerardo Rosati, Francesca Bergamo, Silvio Ken Garattini, Maria Banzi, Maria Zampino, Silvia Bozzarelli, Paolo Marchetti, Fabio Galli, Francesca Galli, Raffaella Longarini, Alberto Zaniboni, Daris Ferrari, Sabino De Placido, Luca Giovanni Frassineti, Mario Nicolini, Saverio Cinieri, Michele Priscindiaro, Pina Ziranu, Riccardo Caccialanza, Alessandro Pastorino, Stefania Mosconi, Giuseppe Aprile

Journal: Clinical colorectal cancer 2023;22(2):190-198

PMID: 36935327

Full Text on Elsevier Science View on PubMed

Abstract

BACKGROUND

High body mass index (BMI) plays a key role in the development of colon cancer (CC). Our post-hoc analysis from the TOSCA trial analyzed the association between BMI and survival outcomes in terms of relapse-free survival (RFS) and overall survival (OS) in stage II/III CC patients.

PATIENTS AND METHODS

Patients enrolled in the TOSCA trial between 2007-2013 with BMI data entered the study. The prognostic impact of BMI on survival outcomes was investigated through uni- and multivariable Cox regression analyses.

RESULTS

Overall, 1455 patients with stage II/III CC patients were included. The median follow-up was of 61.5 months; 16.1% of patients relapsed, 11.2% died and 19.5% patients relapsed or died. No impact of BMI on RFS was detected at univariate or multivariable analyses. By univariate analysis for OS, a significantly impact of a BMI > 30 kg/m was reported (HR [>30 vs <25] 1.57, 95% CI 1.00-2.47, p = 0.049; HR [>30 vs <30] 1.55, 95% CI 1.01-2.37, p = 0.045). Multivariable analyses did not confirm this data. In the subgroup of stage III patients, a negative survival impact of BMI was found in univariate and multivariable models both for RFS and for OS.

CONCLUSIONS

In our study, obesity with BMI > 30 kg/m was an independent prognostic factor for RFS and OS in CC patients treated with adjuvant chemotherapy, regardless of its duration (3 or 6 months). However, the prognostic impact of adiposity and body composition measurement should be considered to better classify patients with high visceral fat and refine their risk assessment.

Address: Department of Medical Oncology, San Bortolo General Hospital, Vicenza, Italy.; Medical Oncology Unit, San Carlo Hospital, Potenza, Italy.; Medical Oncology Unit 1, Istituto Oncologico Veneto-IOV IRCCS, Padova, Italy.; Medical Oncology Unit, Azienda Ospedaliero Universitaria Santa Maria della Misericordia, Udine, Italy.; Medical Oncology Unit, AUSL-IRCCS, Reggio Emilia, Italy.; Division of Gastrointestinal Medical Oncology and Neuroendocrine Tumors, Istituto Europeo di Oncologia-IRCCS, Milano, Italy.; Medical Oncology and Hematology Unit, Humanitas Cancer Center, IRCCS Humanitas Research Hospital, Rozzano (MI), Italy.; Medical Oncology Unit Sant'Andrea Hospital, Sapienza University of Rome and IRCCS Istituto Dermopatico dell'Immacolata, Rome, Italy.; Methodology for Clinical Research Laboratory, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.; Medical Oncology Unit San Gerardo Hospital, Monza, Italy.; Medical Oncology Unit, Fondazione Poliambulanza, Brescia, Italy.; Medical Oncology Unit, Azienda Ospedaliera San Paolo, Milano, Italy.; Medical Oncology Unit Università Federico II, Napoli, Italy.; Medical Oncology Unit IRCCS Istituto Scientifico Romagnolo per lo Studio e la Cura dei Tumori, Meldola (FO), Italy.; Medical Oncology Unit Azienda USL Romagna, Cattolica, Rimini, Italy.; Medical Oncology Unit Ospedale Antonio Perrino, Brindisi, Italy.; Medical Oncology Unit1, Fondazione Istituto Nazionale Tumori-IRCCS, Milano, Italy.; Medical Oncology, University Hospital and University of Cagliari, Cagliari, Italy.; Clinical Nutrition and Dietetics Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.; Medical Oncology Unit, IRCCS San Martino-IST-Genova, Genova, Italy.; Cancer Center ASST Papa Giovanni XXIII, Bergamo, Italy.; Department of Medical Oncology, San Bortolo General Hospital, Vicenza, Italy. Electronic address: [email protected].

DOI: 10.1016/j.clcc.2023.01.004

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MeSH Terms: Humans, Body Mass Index, Chemotherapy, Adjuvant, Colonic Neoplasms, Neoplasm Staging, Obesity, Prognosis