Association of Obesity With Survival Outcomes in Patients With Cancer

作者：Fausto Petrelli, Alessio Cortellini, Alice Indini, Gianluca Tomasello, Michele Ghidini, Olga Nigro, Massimiliano Salati, Lorenzo Dottorini, Alessandro Iaculli, Antonio Varricchio, Valentina Rampulla, Sandro Barni, Mary Cabiddu, Antonio Bossi, Antonio Ghidini, Alberto Zaniboni · 发表于：JAMA Network Open · 年份：2021 · DOI：10.1001/jamanetworkopen.2021.3520 · 被引用次数：518 · 研究领域：Cancer Risks and Factors、Metabolism, Diabetes, and Cancer、Nutrition and Health in Aging

Importance: Obesity, defined as a body mass index (BMI) greater than 30, is associated with a significant increase in the risk of many cancers and in overall mortality. However, various studies have suggested that patients with cancer and no obesity (ie, BMI 20-25) have worse outcomes than patients with obesity. Objective: To assess the association between obesity and outcomes after a diagnosis of cancer. Data Sources: PubMed, the Cochrane Library, and EMBASE were searched from inception to January 2020. Study Selection: Studies reporting prognosis of patients with obesity using standard BMI categories and cancer were included. Studies that used nonstandard BMI categories, that were limited to children, or that were limited to patients with hematological malignant neoplasms were excluded. Screening was performed independently by multiple reviewers. Among 1892 retrieved studies, 203 (17%) met inclusion criteria for initial evaluation. Data Extraction and Synthesis: The Meta-analysis of Observational Studies in Epidemiology (MOOSE) and Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guidelines were reporting guideline was followed. Data were extracted by multiple independent reviewers. Risk of death, cancer-specific mortality, and recurrence were pooled to provide an adjusted hazard ratio (HR) with a 95% CI . A random-effects model was used for the retrospective nature of studies. Main Outcomes and Measures: The primary outcome of the study...