Advanced lung cancer – does BMI matter?

Abstract

Introduction: Body mass index (BMI) is a measure used for indicating nutritional status and was initially developed as a risk indicator of disease. Despite that, only a few have studied the relation between BMI and lung cancer. Aims: Characterize and analyse demographic data, disease factors in advanced stage lung cancer patients and impact of pre-treatment BMI on outcome. Methods: Retrospective analysis of lung cancer patients diagnosed in a tertiary hospital over 3 years; demographic data, tumour characteristics, estimated overall survival (EOS) and estimated progression free survival (EPFS) were analysed. Results: 270 patients had advanced stage cancer (IIIB and IV); median age was 67 years old (min.32;max.93) and median BMI 24.2kg/m 2 . The majority were male (n=212; 78.4%), had smoking history (74%) and Zubrod performance status 1 (44.8%). Adenocarcinoma was found in 53.3%, followed by squamous cell carcinoma 23.3%. Median EOS was 9.5 months and EPFS was 6.8 months. 180 patients (66.7%) died during the time of the analysis. Comparing four BMI categories (BMI: 2 and with BMI 2 , the former had significantly longer EOS (13.8 vs. 8.3 months, p=0.038) as well as EPFS (8.0 vs. 5.9 months, p=0.044). Conclusion: In this group of advanced stage lung cancer patients, BMI didn’t show impact on survival, although those with overweight (≥25kg/m 2 ) had longer EOS and EPFS. Nonetheless, lung cancer patients should undergo early nutritional evaluation to avoid decline of their nutritional status, which could lead to worse outcomes.