Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials

Publication date: July 2018
Source:European Journal of Cancer, Volume 98
Author(s): Thomas Aparicio, Michel Ducreux, Roger Faroux, Emilie Barbier, Sylvain Manfredi, Thierry Lecomte, Pierre-Luc Etienne, Laurent Bedenne, Jaafar Bennouna, Jean-Marc Phelip, Eric François, Pierre Michel, Jean-Louis Legoux, Mohamed Gasmi, Gilles Breysacher, Philippe Rougier, Aimery De Gramont, Come Lepage, Olivier Bouché, Jean-François Seitz
BackgroundPrevious studies showed that high and low body mass index (BMI) was associated with worse prognosis in early-stage colorectal cancer (CRC), and low BMI was associated with worse prognosis in metastatic CRC (mCRC). We aimed to assess efficacy outcomes according to BMI.Patients and methodsA pooled analysis of individual data from 2085 patients enrolled in eight FFCD first-line mCRC trials from 1991 to 2013 was performed. Comparisons were made according to the BMI cut-off: Obese (BMI ≥30), overweight patients (BMI ≥ 25), normal BMI patients (BMI: 18.5–24) and thin patients (BMI <18.5). Interaction tests were performed between BMI effect and sex, age and the addition of antiangiogenics to chemotherapy.ResultsThe rate of BMI ≥25 patients was 41.5%, ranging from 37.6% (1991–1999 period) to 41.5% (2000–2006 period) and 44.8% (2007–2013 period). Comparison of overweight patients versus normal BMI range patients revealed a significant improvement of median overall survival (OS) (18.5 versus 16.3 months, HR = 0.88 [0.80–0.98] p = 0.02) and objective response rate (ORR) (42% versus 36% OR = 1.23 [1.01–1.50] p = 0.04) but a comparable median progression-free survival (PFS) (7.8 versus 7.2 months, HR = 0.96 [0.87–1.05] p = 0.35). Subgroup analyses revealed that overweight was significantly associated with better OS in men. OS and PFS were significantly shorter in thin patients.ConclusionOverweight patients had a prolonged OS compared with normal weight patients with mCRC. The association of overweight with better OS was only observed in men. The pejorative prognosis of BMI <18.5 was confirmed.



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