Prediagnostic body weight and survival in high grade glioma

• Type of Material: Article
• Authors: Erin M. Siegel, University of South Florida; L. Burton Nabors, University of Alabama Birmingham; Reid C. Thompson, Vanderbilt University; Jeffrey James Olson, Emory University; James E. Browning, University of South Florida; Melissa H. Madden, University of South Florida; Gang Han, University of South Florida; Kathleen M. Egan, University of South Florida
• Language: English
• Date: 2013-08-01
• Publisher: Springer Verlag (Germany)
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2013 Springer Science+Business Media New York.
• Final Published Version (URL): http://dx.doi.org/10.1007/s11060-013-1150-2
• Title of Journal or Parent Work: Journal of Neuro-Oncology
• ISSN: 0167-594X
• Volume: 114
• Issue: 1
• Start Page: 79
• End Page: 84
• Grant/Funding Information: The project was supported by the National Institutes of Health (R01CA116174) and institutional funding provided by the Moffitt Cancer Center (Tampa, FL) and the Vanderbilt-Ingram Comprehensive Cancer Center (Nashville, TN).
• Keywords: OBESITY; CANCER; Science & Technology; Glioma; HYPERGLYCEMIA; Survival prediagnostic body weight; Glioblastoma; BMI; Clinical Neurology; Neurosciences & Neurology; Oncology; ASSOCIATION; Life Sciences & Biomedicine
• Research Categories: Health Sciences, Oncology; Biology, Neuroscience

Abstract

Greater adiposity has been linked to an increased risk and/or poorer survival in a variety of cancers. We examined whether prediagnostic body weight 1-5 years prior to diagnosis is associated with survival in patients with high grade glioma. The analysis was based on a series of patients with high-grade glioma (N = 853) enrolled in a US-based multicenter case-control study. Subjects reported height and weight 1-5 years prior to interview and at age 21. BMI was categorized according to WHO criteria as underweight (BMI <18.5 kg/m 2), normal weight (BMI 18.5-24.9 kg/m2), overweight (BMI 25-29.9 kg/m2) and obese (BMI ≥30 kg/m2). Proportional hazards regression was used to estimate hazard ratios (HR) and 95 % confidence intervals (CIs) for glioma-related death according to body mass index (BMI, kg/m2). Overall survival was reduced among patients underweight (median survival: 12.0 months) or obese (median: 13.6 months) when compared to patients of normal weight (median: 17.5 months) prior to glioma diagnosis (p = 0.004). In a multivariate model controlling for other prognostic factors, an excess mortality was observed in patients reporting obese body weights 1-5 years prior to study interview when compared to patients with a normal BMI (HR = 1.32; 95 % CI 1.04-1.68). Consistent patterns of association with excess body weight were observed in men and women, and all findings were similar regardless of treatment for glioma. A lower than optimal body weight was associated with a nonsignificant excess mortality in multivariate analysis. Premorbid obesity was significantly associated with a poor patient outcome independent of treatment and established prognostic factors. Excess body weight may be an adverse prognostic factor in glioma, a relationship observed across a spectrum of cancer types. The current findings linking prediagnostic body weight with mortality in high-grade glioma warrant further research.