scholarly journals Clinical verification of body mass index and tumor immune response in patients with breast cancer receiving preoperative chemotherapy

2021 ◽  
Author(s):  
Koji Takada ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Sae Ishihara ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Preoperative Chemotherapy ◽  
Early Stage ◽  
The Body ◽  
World Health ◽  
Cancer Type ◽  
Immune Microenvironment ◽  
Tumor Immune Microenvironment

Abstract Purpose The body mass index (BMI) is commonly used as a simple indicator of obesity; patients with early-stage breast cancer who are obese (OB) per BMI measurements have been shown to have high postoperative recurrence and low survival rates. On the other hand, it has been shown that lymphocytes present in the vicinity of malignant growths that are involved in the tumors’ immune responses influence the efficacy chemotherapy. Therefore, we hypothesized that OB patients with breast cancer have a lower density of tumor-infiltrating lymphocytes (TILs), which may influence the therapeutic effect of preoperative chemotherapy (POC). In this study, we measured pretreatment BMI and TILs in patients with breast cancer who underwent POC, examined the correlations between these two factors, and retrospectively analyzed their therapeutic outcomes and prognoses. Methods The participants in this study were 421 patients with breast cancer who underwent surgical treatment after POC between February 2007 and January 2019. The patient’s height and weight were measured before POC to calculate the BMI (weight [kg] divided by the square of the height [m2]). According to the World Health Organization categorization, patients who weighed under 18.5 kg/m2 were classified as underweight (UW), those ≥ 18.5 kg/m2 and > 25 kg/m2 were considered normal weight (NW), those ≥ 25 kg/m2 and < 30 kg/m2 were overweight (OW), and those ≥ 30 kg/m2 were OB. The TILs were those lymphocytes that infiltrated the tumor stroma according to the definition of the International TILs Working Group 2014. Results The median BMI was 21.9 kg/m2 (range, 14.3–38.5 kg/m2); most patients (244; 64.5%) were NW. Among all 378 patients with breast cancer, the TIL density was significantly lower in OB than in NW and OW patients (vs. NW: p = 0.001; vs. OW: p = 0.003). Furthermore, when examining patients with each breast cancer type individually, the OS of those with TNBC who had low BMIs was significantly poorer than that of their high-BMI counterparts (log rank p = 0.031). Conclusions Our data did not support the hypothesis that obesity affects the tumor immune microenvironment; however, we showed that being UW does affect the tumor immune microenvironment.

scholarly journals Clinical verification of body mass index and tumor immune response in patients with breast cancer receiving preoperative chemotherapy

2021 ◽  
Author(s):  
Koji Takada ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Rika Kouhashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Preoperative Chemotherapy ◽  
Early Stage ◽  
The Body ◽  
World Health ◽  
Cancer Type ◽  
Immune Microenvironment ◽  
Tumor Immune Microenvironment

Abstract Purpose: The body mass index (BMI) is commonly used as a simple indicator of obesity; patients with early-stage breast cancer who are obese (OB) per BMI measurements have been shown to have high postoperative recurrence and low survival rates. On the other hand, it has been shown that lymphocytes present in the vicinity of malignant growths that are involved in the tumors’ immune responses influence the efficacy chemotherapy. Therefore, we hypothesized that OB patients with breast cancer have a lower density of tumor-infiltrating lymphocytes (TILs), which may influence the therapeutic effect of preoperative chemotherapy (POC). In this study, we measured pretreatment BMI and TILs in patients with breast cancer who underwent POC, examined the correlations between these two factors, and retrospectively analyzed their therapeutic outcomes and prognoses.Methods: The participants in this study were 421 patients with breast cancer who underwent surgical treatment after POC between February 2007 and January 2019. The patient’s height and weight were measured before POC to calculate the BMI (weight [kg] divided by the square of the height [m2]). According to the World Health Organization categorization, patients who weighed under 18.5 kg/m2 were classified as underweight (UW), those ≥18.5 kg/m2 and >25 kg/m2 were considered normal weight (NW), those ≥25 kg/m2 and <30 kg/m2 were overweight (OW), and those ≥30 kg/m2 were OB. The TILs were those lymphocytes that infiltrated the tumor stroma according to the definition of the International TILs Working Group 2014.Results: The median BMI was 21.9 kg/m2 (range, 14.3–38.5 kg/m2); most patients (244; 64.5%) were NW. Among all 378 patients with breast cancer, the TIL density was significantly lower in OB than in NW and OW patients (vs. NW: p=0.001; vs. OW: p=0.003). Furthermore, when examining patients with each breast cancer type individually, the OS of those with TNBC who had low BMIs was significantly poorer than that of their high-BMI counterparts (log rank p=0.031).Conclusions: Our data did not support the hypothesis that obesity affects the tumor immune microenvironment; however, we showed that being UW does affect the tumor immune microenvironment.

scholarly journals Clinical Verification of Body Mass Index and Tumor Immune Response in Patients With Breast Cancer Receiving Preoperative Chemotherapy

2020 ◽  
Author(s):  
Koji Takada ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Rika Kouhashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Preoperative Chemotherapy ◽  
Early Stage ◽  
The Body ◽  
World Health ◽  
Cancer Type ◽  
Immune Microenvironment ◽  
Tumor Immune Microenvironment

Abstract Background: The body mass index (BMI) is commonly used as a simple indicator of obesity; patients with early-stage breast cancer who are obese (OB) per BMI measurements have been shown to have high postoperative recurrence and low survival rates. On the other hand, it has been shown that lymphocytes present in the vicinity of malignant growths that are involved in the tumors’ immune responses influence the efficacy chemotherapy. Therefore, we hypothesized that OB patients with breast cancer have a lower density of tumor-infiltrating lymphocytes (TILs), which may influence the therapeutic effect of preoperative chemotherapy (POC). In this study, we measured pretreatment BMI and TILs in patients with breast cancer who underwent POC, examined the correlations between these two factors, and retrospectively analyzed their therapeutic outcomes and prognoses.Methods: The participants in this study were 421 patients with breast cancer who underwent surgical treatment after POC between February 2007 and January 2019. The patient’s height and weight were measured before POC to calculate the BMI (weight [kg] divided by the square of the height [m2]). According to the World Health Organization categorization, patients who weighed under 18.5 kg/m2 were classified as underweight (UW), those ≥18.5 kg/m2 and >25 kg/m2 were considered normal weight (NW), those ≥25 kg/m2 and <30 kg/m2 were overweight (OW), and those ≥30 kg/m2 were OB. The TILs were those lymphocytes that infiltrated the tumor stroma according to the definition of the International TILs Working Group 2014.Results: The median BMI was 21.9 kg/m2 (range, 14.3–38.5 kg/m2); most patients (244; 64.5%) were NW. Among all 378 patients with breast cancer, the TIL density was significantly lower in OB than in NW and OW patients (vs. NW: p=0.001; vs. OW: p=0.003). Furthermore, when examining patients with each breast cancer type individually, the OS of those with TNBC who had low BMIs was significantly poorer than that of their high-BMI counterparts (log rank p=0.031).Conclusion: Our data did not support the hypothesis that obesity affects the tumor immune microenvironment; however, we showed that being UW does affect the tumor immune microenvironment.

scholarly journals Clinical Verification of Body Mass Index and Tumor Immune Response in Patients With Breast Cancer Receiving Preoperative Chemotherapy

2021 ◽  
Author(s):  
Koji Takada ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Rika Kouhashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Preoperative Chemotherapy ◽  
Early Stage ◽  
Normal Weight ◽  
World Health ◽  
Cancer Type ◽  
Immune Microenvironment ◽  
Tumor Immune Microenvironment

Abstract PurposeThe body mass index (BMI) is commonly used as a simple indicator of obesity; patients with early-stage breast cancer who are obese (OB) per BMI measurements have been shown to have high postoperative recurrence and low survival rates. On the other hand, it has been shown that lymphocytes present in the vicinity of malignant growths that are involved in the tumors’ immune responses influence the efficacy chemotherapy. Therefore, we hypothesized that OB patients with breast cancer have a lower density of tumor-infiltrating lymphocytes (TILs), which may influence the therapeutic effect of preoperative chemotherapy (POC). In this study, we measured pretreatment BMI and TILs in patients with breast cancer who underwent POC, examined the correlations between these two factors, and retrospectively analyzed their therapeutic outcomes and prognoses.MethodsThe participants in this study were 421 patients with breast cancer who underwent surgical treatment after POC between February 2007 and January 2019. The patient’s height and weight were measured before POC to calculate the BMI (weight [kg] divided by the square of the height [m2]). According to the World Health Organization categorization, patients who weighed under 18.5 kg/m2 were classified as underweight (UW), those ≥18.5 kg/m2 and >25 kg/m2 were considered normal weight (NW), those ≥25 kg/m2 and <30 kg/m2 were overweight (OW), and those ≥30 kg/m2 were OB. The TILs were those lymphocytes that infiltrated the tumor stroma according to the definition of the International TILs Working Group 2014.ResultsThe median BMI was 21.9 kg/m2 (range, 14.3–38.5 kg/m2); most patients (244; 64.5%) were NW. Among all 378 patients with breast cancer, the TIL density was significantly lower in OB than in NW and OW patients (vs. NW: p=0.001; vs. OW: p=0.003). Furthermore, when examining patients with each breast cancer type individually, the OS of those with TNBC who had low BMIs was significantly poorer than that of their high-BMI counterparts (log rank p=0.031).ConclusionsOur data did not support the hypothesis that obesity affects the tumor immune microenvironment; however, we showed that being UW does affect the tumor immune microenvironment.

scholarly journals Clinical Verification of Body Mass Index and Tumor Immune Response in Patients With Breast Cancer Receiving Preoperative Chemotherapy

2021 ◽  
Author(s):  
Koji Takada ◽  
Shinichiro Kashiwagi ◽  
Yuka Asano ◽  
Wataru Goto ◽  
Rika Kouhashi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Body Mass ◽  
Preoperative Chemotherapy ◽  
Early Stage ◽  
Normal Weight ◽  
World Health ◽  
Cancer Type ◽  
Immune Microenvironment ◽  
Tumor Immune Microenvironment

Abstract PurposeThe body mass index (BMI) is commonly used as a simple indicator of obesity; patients with early-stage breast cancer who are obese (OB) per BMI measurements have been shown to have high postoperative recurrence and low survival rates. On the other hand, it has been shown that lymphocytes present in the vicinity of malignant growths that are involved in the tumors’ immune responses influence the efficacy chemotherapy. Therefore, we hypothesized that OB patients with breast cancer have a lower density of tumor-infiltrating lymphocytes (TILs), which may influence the therapeutic effect of preoperative chemotherapy (POC). In this study, we measured pretreatment BMI and TILs in patients with breast cancer who underwent POC, examined the correlations between these two factors, and retrospectively analyzed their therapeutic outcomes and prognoses.MethodsThe participants in this study were 421 patients with breast cancer who underwent surgical treatment after POC between February 2007 and January 2019. The patient’s height and weight were measured before POC to calculate the BMI (weight [kg] divided by the square of the height [m2]). According to the World Health Organization categorization, patients who weighed under 18.5 kg/m2 were classified as underweight (UW), those ≥18.5 kg/m2 and >25 kg/m2 were considered normal weight (NW), those ≥25 kg/m2 and <30 kg/m2 were overweight (OW), and those ≥30 kg/m2 were OB. The TILs were those lymphocytes that infiltrated the tumor stroma according to the definition of the International TILs Working Group 2014.ResultsThe median BMI was 21.9 kg/m2 (range, 14.3–38.5 kg/m2); most patients (244; 64.5%) were NW. Among all 378 patients with breast cancer, the TIL density was significantly lower in OB than in NW and OW patients (vs. NW: p=0.001; vs. OW: p=0.003). Furthermore, when examining patients with each breast cancer type individually, the OS of those with TNBC who had low BMIs was significantly poorer than that of their high-BMI counterparts (log rank p=0.031).ConclusionsOur data did not support the hypothesis that obesity affects the tumor immune microenvironment; however, we showed that being UW does affect the tumor immune microenvironment.

To Determine the Prevalence of Obesity in Breast Cancer Patients

2021 ◽  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Cancer Patients ◽  
Body Mass ◽  
Tertiary Care ◽  
Overweight And Obesity ◽  
World Health ◽  
Care Hospital ◽  
Breast Cancer Patients ◽  
Prevalence Of Obesity

Background: Breast Cancer is one of the leading causes of death worldwide. Pakistan alone has the highest rate of Breast Cancer than any other Asian country as approximately 90000 new cases are diagnosed every year out of which 40000 dies. Obesity is also a critical public health problem growing with every passing year in Pakistan and worldwide. Research studies are being conducted worldwide regarding the relation between the two problems. Objective: The objective of this study is to determine the prevalence of obesity in breast cancer patients in a tertiary care hospital in Karachi, Pakistan. Methods: BMI is used as a screening tool for overweight and obesity. According to World Health Organization, a body mass index (BMI) over 25 is considered overweight, and over 30 is obese. A retrospective analysis of 262 patients diagnosed with Breast Cancer during 2019 and 2020 was performed. Patients’ hospital records in Oncology were reviewed. The weight in kilograms and height in centimeters of patients were reviewed. Their BMI was calculated and recorded using the SPSS system. Results: The median BMI was 28.25 kg/m2 with an interquartile range of 25.15 - 31.99 kg/m2. Nearly 80% of the study participants had body mass index higher than normal levels (n=203, 77.5%) and out of them approximately half were overweight (n=104, 51.2%) and the remaining were obese (n=99, 48.7%). Conclusion: We conclude from our study that body mass index is positively correlated with breast cancer occurrence and thus the proportion of females having BMI >= 25 was significantly higher among patients.

Does obesity influence the preferred treatment approach for early-stage cervical cancer? A cost-effectiveness analysis

2021 ◽  
pp. ijgc-2021-003004
Author(s):  
Jacqueline A Bohn ◽  
Miriam L Hernandez-Zepeda ◽  
Alyssa R Hersh ◽  
Elizabeth G Munro ◽  
Jenna M Kahn ◽  
...  
Keyword(s):  
Body Mass Index ◽  
Cervical Cancer ◽  
Cost Effectiveness ◽  
Minimally Invasive ◽  
Body Mass ◽  
Radical Hysterectomy ◽  
Early Stage ◽  
Chemoradiation Therapy ◽  
The Body ◽  
Early Stage Cervical Cancer

ObjectiveAbdominal radical hysterectomy in early-stage cervical cancer has higher rates of disease-free and overall survival compared with minimally invasive radical hysterectomy. Abdominal radical hysterectomy may be technically challenging at higher body mass index levels resulting in poorer surgical outcomes. This study sought to examine the influence of body mass index on outcomes and cost effectiveness between different treatments for early-stage cervical cancer.MethodsA Markov decision-analytic model was designed using TreeAge Pro software to compare the outcomes and costs of primary chemoradiation versus surgery in women with early-stage cervical cancer. The study used a theoretical cohort of 6000 women who were treated with abdominal radical hysterectomy, minimally invasive radical hysterectomy, or primary chemoradiation therapy. We compared the results for three body mass index groups: less than 30 kg/m2, 30–39.9 kg/m2, and 40 kg/m2 or higher. Model inputs were derived from the literature. Outcomes included complications, recurrence, death, costs, and quality-adjusted life years. An incremental cost-effectiveness ratio of less than $100 000 per quality-adjusted life year was used as our willingness-to-pay threshold. Sensitivity analyses were performed broadly to determine the robustness of the results.ResultsComparing abdominal radical hysterectomy with minimally invasive radical hysterectomy, abdominal radical hysterectomy was associated with 526 fewer recurrences and 382 fewer deaths compared with minimally invasive radical hysterectomy; however, abdominal radical hysterectomy resulted in more complications for each body mass index category. When the body mass index was 40 kg/m2 or higher, abdominal radical hysterectomy became the dominant strategy because it led to better outcomes with lower costs than minimally invasive radical hysterectomy. Comparing abdominal radical hysterectomy with primary chemoradiation therapy, recurrence rates were similar, with more deaths associated with surgery across each body mass index category. Chemoradiation therapy became cost effective when the body mass index was 40 kg/m2 or higher.ConclusionWhen the body mass index is 40 kg/m2 or higher, abdominal radical hysterectomy is cost saving compared with minimally invasive radical hysterectomy and primary chemoradiation is cost effective compared with abdominal radical hysterectomy. Primary chemoradiation may be the optimal management strategy at higher body mass indexes.

Anaesthetic Management of a Super Morbid Obese Patient

2021 ◽  
Vol 8 (32) ◽  
pp. 3039-3042
Author(s):  
Lekshmi Raj Jalaja ◽  
Stuti Lohia ◽  
Priyadarsini Bentur ◽  
Ravi Ramgiri
Keyword(s):  
Body Mass Index ◽  
Body Mass ◽  
Recovery Period ◽  
Well Being ◽  
Anaesthetic Management ◽  
The Body ◽  
World Health ◽  
Morbidly Obese ◽  
Multisystem Disorder ◽  
Increased Risk

‘Obesity’ is defined as a condition with excess body fat to the extent that health and well-being are adversely affected and uses a class system based on the body mass index (BMI), by the world health organization (WHO). Anaesthetic management of morbidly obese is challenging, as there is an increased risk of perioperative respiratory insufficiency and supplemental oxygen must be given throughout recovery period. The incidence of morbid obesity continues to grow and anaesthesiologists are exposed to obese patients presenting for various procedures. The prevalence of obesity is on the upward trend worldwide. Obesity is a multisystem disorder, involving the respiratory and cardiovascular systems, and therefore, undergoing a surgical procedure under anaesthesia may entail a considerable risk. Thus, a multidisciplinary approach is required in treating such patients. Quantification of the extent of obesity is done using the body mass index. BMI is defined as the relationship between weight and height (weight [kg] / height2 [m2 ]).

scholarly journals Outcome of breast cancer patients regarding obesity and complications: Analysis of risk factors

2021 ◽  
Vol 68 (1) ◽  
pp. 77-86
Author(s):  
Iuliana Pantelimon ◽  
◽  
Laurentia Nicoleta Gales ◽  
Maria Daniela Tanasescu ◽  
Irina Nita ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Body Mass Index ◽  
Prognostic Factors ◽  
Disease Progression ◽  
Body Mass ◽  
Type Ii Diabetes ◽  
The Body ◽  
Proliferation Index ◽  
Her2 Overexpression ◽  
Type Ii

Introduction. Breast cancer is the leading cause of cancer death in Romania. In the context in which the treatments available for this pathology have increased curability, the identification of negative prognostic factors involved in the evolution of this disease seems essential to improve the overall survival as well as the time to disease progression. Aim. The aim of this study is to identify the role of prognostic factors such as ki67 proliferation index, the presence of tumour estrogen receptors, HER2 overexpression, the presence of secondary determinations at diagnosis, the association of obesity and type II diabetes. Methods. 50 patients diagnosed with breast cancer treated in the Elias University Emergency Hospital Bucharest were retrospectively followed, for which the progression was documented at the time of elaboration of this study. Thus, a database was developed in which data were entered on age, body mass index, immunohistochemical characteristics of breast tumours, the presence/absence of metastases at diagnosis and the association of type II diabetes. Statistical calculations were performed to highlight a possible correlation between obesity (quantified by measuring body mass index) and tumour aggressiveness (quantified by ki67 proliferation index) as well as statistical evaluation of potential prognostic factors that would influence time, until the disease progresses. Results. Within this group, no correlation could be established between the presence of an increased body mass index and the value of the ki67 proliferation index (p = 0.38). The mean value of the body mass index for this group of unselected patients was 28.76 ± 4.81 (DS) most patients are therefore overweight or obese. The factors involved in the evolution of breast cancer that influenced the early progression of the disease were: the proliferation index ki67 (p <0.05), the presence of metastases at diagnosis (p < 0.0001) and the association of type II diabetes (p = 0.0085). The value of the body mass index did not influence the time to disease progression according to statistical calculations in this group probably due to the small number of normal weight patients included (p = 0.34).

scholarly journals Perception of Body Image and Dietary Habit Among Adults Aged 20–45 Years at Sunyani Metropolis

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 277-277
Author(s):  
Jacob Setorglo ◽  
Philip Narteh Gorleku ◽  
Kyei Roselyn ◽  
Kingsley Kwadwo Asare Pereko
Keyword(s):  
Body Mass Index ◽  
Body Image ◽  
Body Size ◽  
Body Mass ◽  
Who Classification ◽  
The Body ◽  
World Health ◽  
Outcome Variable ◽  
Sugar Consumption ◽  
Normal Body

Abstract Objectives The study assessed the body size perception of respondents against the WHO body mass index and related the body sizes to fat and sugar consumption among 20–45-year-old adults. Methods The study design was a descriptive cross-sectional survey which involved 200 respondents aged 20–45 years, sampled conveniently. at Sunyani. Data on socio-demographic, fat and sugar consumption, anthropometry (weight in kg, height in cm) were collected. The weight and height data were later converted into body mass index using the World Health Organisation (WHO) classification. Sugar and fat intakes were measured by dietary food based assessment. (Analysis was done using IBM SPSS version 25. Proportions were presented for categorical values. Chi square test of association was used to determine relationship between the independent and the dependent outcome variable. Statistical significant was set at and P &lt; 0.05. Results The mean age of the respondents was 35 years. About 35.0% of respondents were males and the rest 65.0% females. Sugar and fat consumption among the respondents were within the recommended dietary allowances. Although 75% of respondents had normal body mass index (kg/m2) and 21% were obese based on the WHO classification, Majority (43.0%) of them perceived their body weights were normal. About 48.1% perceived they are either obese or had normal body size. There was no statistically significant association between respondents’ perceived body image and socio-demographic characteristics except for marital status (X2 = 8.82, P = 0.044). There was no statistically significant association between body image perception and dietary intake of fat and sugar. Conclusions There is great disparity in the perception of respondents body image compared to the WHO classification and married women and men are more particular about how they look. Dietary components studied do not have any association with body image. Funding Sources None.

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