Abstract
BackgroundAsian population has different body mass index (BMI) profile compared to Caucasian population. However, the effect of obesity and body weight gain in Asian colorectal cancer patients treated with adjuvant chemotherapy has not been studied thus far.MethodsWe have analyzed the association between disease-free survival (DFS) and obesity/body weight change during treatment in Korean stage III or high-risk stage II colorectal cancer patients treated with adjuvant 5-fluorouracil/ leucovorin/oxaliplatin. BMI was classified according to WHO Asia-Pacific classification. Weight change was calculated by comparing body weights measured at the last chemotherapy cycle and before surgery.ResultsAmong a total of 522 patients, 35.7 % of patients were obese (BMI ≥ 25 kg/m2) and 29.1 % were overweight (BMI, 23–24.9 kg/m2) before surgery. 18.0 % of patients gained ≥ 5 kg and 26.1 % gained 2–4.9 kg during the adjuvant chemotherapy period. Baseline BMI or body weight change was not associated with DFS in the overall study population. However, body weight gain (≥5 kg) was associated with inferior DFS (adjusted hazard ratio 2.04, 95 % confidence interval 1.02–4.08, p = 0.043) in overweight and obese patients (BMI ≥ 23.0 kg/m2).ConclusionIn Korean colorectal cancer patients treated with adjuvant FOLFOX chemotherapy, body weight gain during the treatment period has a negative prognostic influence in overweight and obese patients.
Highlights
Asian population has different body mass index (BMI) profile compared to Caucasian population
Colorectal cancer mortality is declining in the developed countries, its incidence and mortality are increasing in other countries, including Korea, which are probably due to westernization of lifestyle [2, 3]
This study was undertaken to investigate how obesity and body weight change during chemotherapy influences prognosis in Korean colorectal cancer patients receiving adjuvant 5-fluorouracil, leucovorin, and oxaliplatin (FOLFOX) chemotherapy in order to provide preliminary answers to the above questions. Patients and treatment This retrospective analysis was performed with Korean patients who received curative surgery followed by adjuvant FOLFOX chemotherapy at Seoul National University Hospital (SNUH) (Seoul, Korea)
Summary
Asian population has different body mass index (BMI) profile compared to Caucasian population. Colorectal cancer mortality is declining in the developed countries, its incidence and mortality are increasing in other countries, including Korea, which are probably due to westernization of lifestyle [2, 3]. Body mass index (BMI) of ≥ 30.0 kg/m2 and 25.0– 29.9 kg/m2 are proposed by the World Health Organization (WHO) for classification of obesity and overweight, respectively [4]. The prevalence of obesity is higher than 20 % in many countries in Western Europe and North America, whereas it is less than 10 % in Asian countries including Korea and Japan [5]. In Korea, BMI cut-off of 25 kg/m2 and 23.0–24.9 kg/m2 is used for the definition of obesity and overweight, respectively [8, 9]
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