The relationship between body mass index (BMI) and cancer outcomes has long intrigued researchers. For patients with advanced biliary tract cancer, understanding how BMI influences survival could guide treatment and management strategies. Despite previous studies linking excess body weight to cancer progression, new research reveals that BMI may not significantly impact survival in these patients.
A comprehensive study involving 360 patients receiving gemcitabine-based chemotherapy for advanced biliary tract cancer explored the connection between BMI and overall survival (OS). Researchers utilized the Cox regression model to calculate hazard ratios (HRs) and 95% confidence intervals (CIs) for OS, adjusting for potential confounders.
Clinical Cohort Findings
In the clinical cohort, BMI showed no significant association with overall survival (Ptrend = 0.34). Patients with BMI 2 and those with BMI ≥ 25.0 kg/m2 had adjusted HRs for OS of 1.06 (95% CI, 0.78-1.45) and 1.01 (95% CI, 0.74-1.39), respectively, when compared to patients with BMI between 18.5-24.9 kg/m2. Additionally, there was no evidence of a non-linear relationship between BMI and OS (Pnonlinearity = 0.63).
Nationwide Database Validation
To validate these findings, the study extended to a Japanese nationwide inpatient database including 8324 patients from 201 hospitals. The results corroborated the initial findings, with adjusted HRs of 1.07 (95% CI, 0.98-1.18) for BMI 2 and 1.05 (95% CI, 0.96-1.14) for BMI ≥ 25.0 kg/m2 compared to the reference group (BMI 18.5-24.9 kg/m2). The trend analysis also indicated no significant association (Ptrend = 0.18).
In terms of progression-free survival, the clinical cohort study found no significant correlation with BMI (Ptrend = 0.81).
Practical Implications for Healthcare Providers
– BMI alone should not be used as a prognostic factor for survival in advanced biliary tract cancer.
– Further studies should consider more detailed body composition metrics, such as muscle mass and fat distribution.
– Clinicians should focus on individualized treatment plans rather than relying solely on BMI.
The findings underscore the complexity of cancer prognosis and suggest that BMI might not be a reliable indicator for survival outcomes in patients with advanced biliary tract cancer. Future research should incorporate more nuanced measures of body composition to fully understand the role of adiposity in cancer prognosis.
Original Article:
J Gastroenterol. 2024 Jun 19. doi: 10.1007/s00535-024-02124-9. Online ahead of print. PMID: 38896254 | DOI: 10.1007/s00535-024-02124-9
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