Correlation of Body Mass Index with Oncologic Outcomes in Colorectal Cancer Patients: A Large Population-Based Study
Journal
Cancers
Journal Volume
13
Journal Issue
14
Date Issued
2021-07-17
Author(s)
Chiu, Chong-Chi
Ho, Chung-Han
Hung, Chao-Ming
Chao, Chien-Ming
Lai, Chih-Cheng
Chen, Chin-Ming
Liao, Kuang-Ming
Wang, Jhi-Joung
Wu, Yu-Cih
Shi, Hon-Yi
Lee, Hui-Ming
Yeh, Li-Ren
Soong, Tien-Chou
Chiang, Shyh-Ren
Cheng, Kuo-Chen
Abstract
It has been acknowledged that excess body weight increases the risk of colorectal cancer (CRC); however, there is little evidence on the impact of body mass index (BMI) on CRC patients' long-term oncologic results in Asian populations. We studied the influence of BMI on overall survival (OS), disease-free survival (DFS), and CRC-specific survival rates in CRC patients from the administrative claims datasets of Taiwan using the Kaplan-Meier survival curves and the log-rank test to estimate the statistical differences among BMI groups. Underweight patients (<18.50 kg/m2) presented higher mortality (56.40%) and recurrence (5.34%) rates. Besides this, they had worse OS (aHR:1.61; 95% CI: 1.53-1.70; p-value: < 0.0001) and CRC-specific survival (aHR:1.52; 95% CI: 1.43-1.62; p-value: < 0.0001) rates compared with those of normal weight patients (18.50-24.99 kg/m2). On the contrary, CRC patients belonging to the overweight (25.00-29.99 kg/m2), class I obesity (30.00-34.99 kg/m2), and class II obesity (≥35.00 kg/m2) categories had better OS, DFS, and CRC-specific survival rates in the analysis than the patients in the normal weight category. Overweight patients consistently had the lowest mortality rate after a CRC diagnosis. The associations with being underweight may reflect a reverse causation. CRC patients should maintain a long-term healthy body weight.
Subjects
body mass index
colorectal cancer
colorectal cancer-specific survival
disease-free survival
oncologic prognosis
overall survival
Type
journal article