한빛사논문
- 조회617
Ji Hyun Lee 1, Danbee Kang 2, Jin Seok Ahn 3, Eliseo Guallar 4, Juhee Cho 2,4,5, Ho Yun Lee 1,6
1Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2Department of Clinical Research Design and Evaluation, The Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
3Department of Medicine, Division of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
4Department of Epidemiology and Medicine and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA.
5Center for Clinical Epidemiology, Samsung Medical Center, Sungkyunkwan University, Seoul, Republic of Korea.
6Department of Health Sciences and Technology, The Samsung Advanced Institute for Health Sciences & Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
Ji Hyun Lee and Danbee Kang contributed equally to this work.
CORRESPONDING AUTHORS : Juhee Cho, Ho Yun Lee
Abstract
Background: The obesity paradox in patients with advanced non-small cell lung cancer receiving immune checkpoint inhibitor therapy has been observed, but its underlying mechanism is not fully understood. We aimed to investigate whether body composition affects the prognostic impact of obesity, as determined by body mass index (BMI), on survival.
Methods: This retrospective study evaluated the data collected from Asian patients who were treated with immune checkpoint inhibitors for advanced non-small cell lung cancer between October 2015 and October 2021. We used abdominal cross-sectional imaging to calculate the skeletal muscle and visceral fat indices (cm2 /m2 ) by dividing the cross-sectional areas of the skeletal muscle and visceral fat by the height squared. Cox proportional-hazards regression was performed to determine the correlation between BMI according to the Asia-Pacific classification, body composition metrics and overall survival.
Results: We analysed the data of 820 patients (630 men and 190 women, with a mean age of 64.3 years [standard deviation: 10.4 years]) and observed 572 (69.8%) deaths with the 1-year mortality rate of 0.58 (95% confidence interval, 0.55-0.62). Obese BMI was associated with longer overall survival, independent of clinical covariates (hazard ratio, 0.64; 95% confidence interval: 0.52-0.80). The prognostic value of obese BMI remained after additional adjustments for skeletal muscle index (hazard ratio, 0.68; 95% confidence interval, 0.53-0.87) or visceral fat index (hazard ratio, 0.54; 95% confidence interval: 0.41-0.70). No association was observed between sex and the impact of BMI on overall survival (P-value for interaction >0.05).
Conclusions: In Asian patients with advanced non-small cell lung cancer who received immune checkpoint inhibitors, obese BMI was associated with favourable overall survival independent of skeletal muscle or visceral fat mass.
논문정보
- Research article
- 2023년 11월 (BRIC 등록일 2023-11-16)
- 국내(교신)+국외 연구진
- 의약학 > 응용의학
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