P04 - Body Mass Index (BMI) e quality of life (QoL) in cancer patients – the ‘Tor Vergata’ Observational study in oNCOlogy– TV-ONCO study

Abstract

Background: Obesity has been consistently linked to an increased risk of developing cancer. A recent retrospective study on > 8000 pts has found longer survival in pts with metastatic cancer and high BMI (Martin.J Clin Oncol. 2015). Data on the effect of BMI on the Health-related quality of life (HRQoL), are scarce. The purpose of this study was to evaluate the effect of BMI on QoL in pts with metastatic or inoperable cancer.Methods: We prospectively evaluated the association between baseline BMI and the HRQoL among 136 pts with metastatic or inoperable cancer. Quality of life was measured through the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-C30, version3.0). Associations between BMI and QoL were determined by means of univariate and multivariate analysis. We classified our patients on the basis of their BMI status (underweight <18.5 kg/m2, normal weight 18.5-24.9 kg/m2, overweight 25–29.9 kg/m2, obese > 30 kg/m2), sex, number of sites of metastases (inoperable or one site, two sites, more than two sites), cancer primary site (breast, lung, upper GI, colorectum, GU, other).Results: Among recruited pts 5 were underweight (3.7%), 59 normal weight (43.4%), 46 overweight (33.8%) and 26 obese (19.1%). Male 56 (41.1%) and female 80 (58.9%). Pts inoperable or one site of metastases 26 (19.1%); pts with two and more than two sites of metastases were 63 (46.3%) and 47 (34.6%), respectively. Primary sites were GU (n 20, 14.7%), upper GI (n 18, 13.2%), colorectum (n 46, 33.8%), breast (n 25, 18.4%), lung (n 17, 12.5%), or other (n 10, 7.4%). Median Global Health Status (GHS) score was 50 for underweight pts, 50 for normal weight pts, 58 for overweight pts and 67 for obese pts. By dividing pts in BMI quintiles, we found that pts group with lowest BMI category (BMI<18) had a significantly lower median GHS score as compared with the pts group with highest BMI category (BMI>31), 50 vs 75, p 0.02. Other significant differences between these two extreme BMI categories were in Physical Functioning (median score 67v90, p 0.01), Role Functioning (67v100, p 0.02), Emotional Functioning (67v91, p 0.02) and Social Functioning (67v100, p 0.02).Conclusion: Our results show that better HRQoL is associated with higher BMI possibly owing to additional energetic reserve counteracting cachexia. Further studies will need to address whether intensified nutritional support to achieve weight gain is warranted to improve HRQoL. Background: Obesity has been consistently linked to an increased risk of developing cancer. A recent retrospective study on > 8000 pts has found longer survival in pts with metastatic cancer and high BMI (Martin.J Clin Oncol. 2015). Data on the effect of BMI on the Health-related quality of life (HRQoL), are scarce. The purpose of this study was to evaluate the effect of BMI on QoL in pts with metastatic or inoperable cancer. Methods: We prospectively evaluated the association between baseline BMI and the HRQoL among 136 pts with metastatic or inoperable cancer. Quality of life was measured through the European Organisation for Research and Treatment of Cancer (EORTC) quality of life questionnaire (QLQ-C30, version3.0). Associations between BMI and QoL were determined by means of univariate and multivariate analysis. We classified our patients on the basis of their BMI status (underweight <18.5 kg/m2, normal weight 18.5-24.9 kg/m2, overweight 25–29.9 kg/m2, obese > 30 kg/m2), sex, number of sites of metastases (inoperable or one site, two sites, more than two sites), cancer primary site (breast, lung, upper GI, colorectum, GU, other). Results: Among recruited pts 5 were underweight (3.7%), 59 normal weight (43.4%), 46 overweight (33.8%) and 26 obese (19.1%). Male 56 (41.1%) and female 80 (58.9%). Pts inoperable or one site of metastases 26 (19.1%); pts with two and more than two sites of metastases were 63 (46.3%) and 47 (34.6%), respectively. Primary sites were GU (n 20, 14.7%), upper GI (n 18, 13.2%), colorectum (n 46, 33.8%), breast (n 25, 18.4%), lung (n 17, 12.5%), or other (n 10, 7.4%). Median Global Health Status (GHS) score was 50 for underweight pts, 50 for normal weight pts, 58 for overweight pts and 67 for obese pts. By dividing pts in BMI quintiles, we found that pts group with lowest BMI category (BMI<18) had a significantly lower median GHS score as compared with the pts group with highest BMI category (BMI>31), 50 vs 75, p 0.02. Other significant differences between these two extreme BMI categories were in Physical Functioning (median score 67v90, p 0.01), Role Functioning (67v100, p 0.02), Emotional Functioning (67v91, p 0.02) and Social Functioning (67v100, p 0.02). Conclusion: Our results show that better HRQoL is associated with higher BMI possibly owing to additional energetic reserve counteracting cachexia. Further studies will need to address whether intensified nutritional support to achieve weight gain is warranted to improve HRQoL.