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dc.contributor.authorPajares, Bella
dc.contributor.authorPollan-Santamaria, Marina 
dc.contributor.authorMartín, Miguel
dc.contributor.authorMackey, John R
dc.contributor.authorLluch, Ana
dc.contributor.authorGavila, Joaquín
dc.contributor.authorVogel, Charles
dc.contributor.authorRuiz-Borrego, Manuel
dc.contributor.authorCalvo, Lourdes
dc.contributor.authorPienkowski, Tadeusz
dc.contributor.authorRodríguez-Lescure, Álvaro
dc.contributor.authorSeguí, Miguel Angel
dc.contributor.authorTredan, Olivier
dc.contributor.authorAntón, Antonio
dc.contributor.authorRamos, Manuel 
dc.contributor.authorCámara, María del Carmen
dc.contributor.authorRodríguez-Martín, César
dc.contributor.authorCarrasco, Eva
dc.contributor.authorAlba, Emilio
dc.date.accessioned2017-09-04T16:26:48Z
dc.date.available2017-09-04T16:26:48Z
dc.date.issued2013-11-06
dc.identifier.citationBreast Cancer Res. 2013; 15(6): R105
dc.identifier.urihttp://hdl.handle.net/20.500.12105/4802
dc.description.abstractObesity is an unfavorable prognostic factor in breast cancer (BC) patients regardless of menopausal status and treatment received. However, the association between obesity and survival outcome by pathological subtype requires further clarification. METHODS: We performed a retrospective analysis including 5,683 operable BC patients enrolled in four randomized clinical trials (GEICAM/9906, GEICAM/9805, GEICAM/2003-02, and BCIRG 001) evaluating anthracyclines and taxanes as adjuvant treatments. Our primary aim was to assess the prognostic effect of body mass index (BMI) on disease recurrence, breast cancer mortality (BCM), and overall mortality (OM). A secondary aim was to detect differences of such prognostic effects by subtype. RESULTS: Multivariate survival analyses adjusting for age, tumor size, nodal status, menopausal status, surgery type, histological grade, hormone receptor status, human epidermal growth factor receptor 2 (HER2) status, chemotherapy regimen, and under-treatment showed that obese patients (BMI 30.0 to 34.9) had similar prognoses to that of patients with a BMI < 25 (reference group) in terms of recurrence (Hazard Ratio [HR] = 1.08, 95% Confidence Interval [CI] = 0.90 to 1.30), BCM (HR = 1.02, 0.81 to 1.29), and OM (HR = 0.97, 0.78 to 1.19). Patients with severe obesity (BMI ≥ 35) had a significantly increased risk of recurrence (HR = 1.26, 1.00 to 1.59, P = 0.048), BCM (HR = 1.32, 1.00 to 1.74, P = 0.050), and OM (HR = 1.35, 1.06 to 1.71, P = 0.016) compared to our reference group. The prognostic effect of severe obesity did not vary by subtype. CONCLUSIONS: Severely obese patients treated with anthracyclines and taxanes present a worse prognosis regarding recurrence, BCM, and OM than patients with BMI < 25. The magnitude of the harmful effect of BMI on survival-related outcomes was similar across subtypes.
dc.description.sponsorshipThis work was supported by the Spanish Breast Cancer Research Group (Grupo Español de Investigación de Cáncer de Mama) (GEICAM). No funding was received for the data analyses or the writing of this manuscript. Clinical trials GEICAM/9805 and BCIRG 001 were funded by Sanofi Aventis. GEICAM/9906 and GEICAM/2003-02 were partially funded by Bristol-Myers Squibb. These funding bodies were not involved in the collection and interpretation of the data or in the decision to publish. EA and MM were also supported by FEDER (RECTICC-RD12/0036/0076). We thank all the participating patients, clinicians, GEICAM and local research staff. We thank Hosanna Soler Vila, PhD, who provided medical writing services on behalf of GEICAM.
dc.language.isoeng
dc.publisherBioMed Central (BMC) 
dc.type.hasVersionVoR
dc.rights.urihttp://creativecommons.org/licenses/by/2.0/*
dc.titleObesity and survival in operable breast cancer patients treated with adjuvant anthracyclines and taxanes according to pathological subtypes: a pooled analysis
dc.typejournal article
dc.rights.licenseAtribución 2.0*
dc.identifier.pubmedID24192331
dc.format.volume15
dc.format.number6
dc.format.pageR105
dc.identifier.doi10.1186/bcr3572
dc.contributor.funderGrupo Español de Investigación de Cáncer de Mama
dc.contributor.funderSanofi 
dc.contributor.funderBristol-Myers Squibb 
dc.contributor.funderUnión Europea. Fondo Europeo de Desarrollo Regional (FEDER/ERDF) 
dc.description.peerreviewed
dc.identifier.e-issn1465-542X
dc.relation.publisherversionhttps://doi.org/10.1186/bcr3572
dc.identifier.journalBreast Cancer Research
dc.repisalud.centroISCIII::Centro Nacional de Epidemiología
dc.repisalud.institucionISCIII
dc.rights.accessRightsopen accesses_ES


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