Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials

Thomas Aparicio¹, Michel Ducreux², Roger Faroux³, Emilie Barbier⁴, Sylvain Manfredi⁵, Thierry Lecomte⁶, Pierre-Luc Etienne⁷, Laurent Bedenne⁵, Jaafar Bennouna⁸, Jean-Marc Phelip⁹, Eric François¹⁰, Pierre Michel¹¹, Jean-Louis Legoux¹², Mohamed Gasmi¹³, Gilles Breysacher¹⁴, Philippe Rougier¹⁵, Aimery De Gramont¹⁶, Come Lepage⁵, Olivier Bouché¹⁷, Jean-François Seitz¹⁸; for FFCD investigators

Collaborators, Affiliations

Collaborators

for FFCD investigators:
A Adenis, A Alessio, A Aouakli, A Azzedine, A Bedjaoui, A Bidault, A Blanchi, A Botton, A Cadier-Lagnes, A Fatisse, A Gagnaire, A Gilbert, A Gueye, A Hollebecque, A Lemaire, A Mahamat, A Marre, A Patenotte, A Rotenberg, A Roussel, A Thirot-Bidault, A Votte, A Weber, A Zaanan, A C Dupont-Gossart, A L Villing, A M Queuniet, B Coudert, B Denis, B Garcia, B Lafforgue, B Landi, B Leduc, B Linot, B Paillot, B Rhein, B Winkfield, C Barberis, C Becht, C Belletier, C Berger, C Bineau, C Borel, C Brezault, C Buffet, C Cornila, C Couffon, C De La Fouchardière, C Giraud, C Lecaille, C Lepere, C Lobry, C Locher, C Lombard-Bohas, C Paoletti, C Platini, C Rebischung, C Sarda, C Vilain, C Briac-Levaché, D Auby, D Baudet-Klepping, D Bechade, D Besson, D Cleau, D Festin, D Gargot, D Genet, D Goldfain, D Luet, D Malka, D Peré-Vergé, D Pillon, D Sevin-Robiche, D Smith, D Soubrane, D Tougeron, D Zylberait, E Carola, E Cuillerier, E Dorval Danquechin, E Echinard, E Janssen, E Maillard, E Mitry, E Norguet-Monnereau, E Suc, E Terrebonne, E Zrihen, E A Pariente, F Almaric, F Audemar, F Bonnetain, F Desseigne, F Dewaele, F Di Fiore, F Ghiringhelli, F Husseini, F Khemissa, F Kikolski, F Morvan, F Petit-Laurent, F Riot, F Subtil, F Zerouala-Boussaha, F X Caroli-Bosc, G Boilleau-Jolimoy, G Bordes, G Cavaglione, G Coulanjon, G Deplanque, G Gatineau-Saillant, G Goujon, G Medinger, G Roquin, H Brixi-Benmansour, H Castanie, H Lacroix, H Maechel, H Perrier, H Salloum, H Senellart, I Baumgaertner, I Cumin, I Graber, I Trouilloud, J Boutin, J Butel, J Charneau, J Cretin, J Dauba, J Deguiral, J Egreteau, J Ezenfis, J Forestier, J Goineau, J Lacourt, J Lafon, J Martin, J Meunier, J Moreau, J Provencal, J Taieb, J Thaury, J Tuaillon, J Vergniol, J Villand, J Vincent, J Volet, J B Bachet, J C Barbare, J C Souquet, J D Grangé, J F Dor, J F Paitel, J L Jouve, J L Raoul, J M Cheula, J M Gornet, J M Sabate, J M Vantelon, J N Vaillant, J P Aucouturier, J P Barbieux, J P Herr, J P Lafargue, J P Lagasse, J P Latrive, J P Plachot, J P Ramain, J P Robin, J P Spano, J Y Douillard, K Beerblock, K Bouhier-Leporrier, K Slimane Fawzi, L Cany, L Chone, L Dahan, L Gasnault, L Rob, L Stefani, L Wander, M Baconnier, M Ben Abdelghani, M Benchalal, M Blasquez, M Carreiro, M Charbit, M Combe, M Duluc, M Fayolle, M Gignoux, M Giovannini, M Glikmanas, M Mabro, M Mignot, M Mornet, M Mousseau, M Mozer, M Pauwels, M Pelletier, M Porneuf, M Ramdani, M Schnee, M Tissot, M Zawadi, M C Clavero-Fabri, M C Gouttebel, M C Kaminsky, M P Galais, N Abdelli, N Barrière, N Bouaria, N Bouarioua, N Delas, N Gérardin, N Hess-Laurens, N Stremsdoerfer, O Berthelet, O Boulat, O Capitain, O Favre, P Amoyal, P Bergerault, P Burtin, P Cassan, P Chatrenet, P Chiappa, P Claudé, P Couzigou, P Feydy, P Follana, P Geoffroy, P Godeau, P Hammel, P Laplaige, P Lehair, P Martin, P Novello, P Pantioni, P Pienkowski, P Pouderoux, P Prost, P Ruszniewski, P Souillac, P Texereau, P Thévenet, P A Haineaux, R Benoit, R Coriat, R Lamy, R Mackiewicz, S Beorchia, S Chaussade, S Hiret, S Jacquot, S Lavau Denes, S Montembault, S Nahon, S Nasca, S Nguyen, S Oddou-Lagraniere, S Pesque-Penaud, S P Fratte, T Chatellier, T Mansourbakht, T Morin, T Walter, V Boige, V Bourgeois, V Derias, V Guérin-Meyer, V Hautefeuille, V Jestin Le Tallec, V Lorgis, V Quentin, V Sebbagh, V Veuillez, X Adhoute, X Coulaud, Y Becouarn, Y Coscas, Y Courouble, Y Le Bricquir, Y Molin, Y Rinaldi, Y H Lam, Z Ladhib

Affiliations

¹ Gastroenterology Department, CHU Saint Louis, APHP, Paris, France; University Paris 7, Sorbonne Paris Cité, Paris, France. Electronic address: thomas.aparicio@aphp.fr.
² Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
³ Gastroenterology Department, CH La Roche sur Yon, La Roche sur Yon, France.
⁴ Statistics Department, Fédération Francophone de Cancérologie Digestive, Dijon, France; INSERM UMR 1231, Dijon, France.
⁵ Univ. Bourgogne Franche-Comté, INSERM UMR1231, Gastroenterology Department, CHU de Dijon, Dijon, France.
⁶ Gastroenterology Department, CHU Trousseau, Tours, France.
⁷ Oncology Department, CARIO, HPCA, Plérin, France.
⁸ Oncology Department, Institut de Cancérologie de L'Ouest, Saint Herblay, France.
⁹ Gastroenterology Department, CHU Saint Etienne - Hôpital Nord, Saint Priest en Jarez, France.
¹⁰ Gastroenterology Department, Centre Antoine Lacassagne, Nice, France.
¹¹ Gastroenterology Department, Rouen University Hospital, CHU Charles Nicolle, Rouen, France.
¹² Hepato-Gastroenterology and Digestive Oncology Department, CHR La Source, Orléans, France.
¹³ Gastroenterology Department, CHU Hôpital Nord, Marseille, France.
¹⁴ Gastroenterology Department, CH Pasteur, Colmar, France.
¹⁵ Gastroenterology Department, CHU de Nantes, Nantes, France.
¹⁶ Oncology Department, Hôpital Franco-Britanique, Levallois Perret, France.
¹⁷ Digestive Oncology Department, CHU Robert Debré, Reims, France.
¹⁸ Digestive Oncology Department, CHU La Timone, APHM, Aix-Marseille Univ, Marseille, France.

PMID: 29807237
DOI: 10.1016/j.ejca.2018.03.031

Free article

Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials

Thomas Aparicio et al. Eur J Cancer. 2018 Jul.

Free article

. 2018 Jul:98:1-9.

doi: 10.1016/j.ejca.2018.03.031. Epub 2018 May 26.

Authors

Collaborators

for FFCD investigators:
A Adenis, A Alessio, A Aouakli, A Azzedine, A Bedjaoui, A Bidault, A Blanchi, A Botton, A Cadier-Lagnes, A Fatisse, A Gagnaire, A Gilbert, A Gueye, A Hollebecque, A Lemaire, A Mahamat, A Marre, A Patenotte, A Rotenberg, A Roussel, A Thirot-Bidault, A Votte, A Weber, A Zaanan, A C Dupont-Gossart, A L Villing, A M Queuniet, B Coudert, B Denis, B Garcia, B Lafforgue, B Landi, B Leduc, B Linot, B Paillot, B Rhein, B Winkfield, C Barberis, C Becht, C Belletier, C Berger, C Bineau, C Borel, C Brezault, C Buffet, C Cornila, C Couffon, C De La Fouchardière, C Giraud, C Lecaille, C Lepere, C Lobry, C Locher, C Lombard-Bohas, C Paoletti, C Platini, C Rebischung, C Sarda, C Vilain, C Briac-Levaché, D Auby, D Baudet-Klepping, D Bechade, D Besson, D Cleau, D Festin, D Gargot, D Genet, D Goldfain, D Luet, D Malka, D Peré-Vergé, D Pillon, D Sevin-Robiche, D Smith, D Soubrane, D Tougeron, D Zylberait, E Carola, E Cuillerier, E Dorval Danquechin, E Echinard, E Janssen, E Maillard, E Mitry, E Norguet-Monnereau, E Suc, E Terrebonne, E Zrihen, E A Pariente, F Almaric, F Audemar, F Bonnetain, F Desseigne, F Dewaele, F Di Fiore, F Ghiringhelli, F Husseini, F Khemissa, F Kikolski, F Morvan, F Petit-Laurent, F Riot, F Subtil, F Zerouala-Boussaha, F X Caroli-Bosc, G Boilleau-Jolimoy, G Bordes, G Cavaglione, G Coulanjon, G Deplanque, G Gatineau-Saillant, G Goujon, G Medinger, G Roquin, H Brixi-Benmansour, H Castanie, H Lacroix, H Maechel, H Perrier, H Salloum, H Senellart, I Baumgaertner, I Cumin, I Graber, I Trouilloud, J Boutin, J Butel, J Charneau, J Cretin, J Dauba, J Deguiral, J Egreteau, J Ezenfis, J Forestier, J Goineau, J Lacourt, J Lafon, J Martin, J Meunier, J Moreau, J Provencal, J Taieb, J Thaury, J Tuaillon, J Vergniol, J Villand, J Vincent, J Volet, J B Bachet, J C Barbare, J C Souquet, J D Grangé, J F Dor, J F Paitel, J L Jouve, J L Raoul, J M Cheula, J M Gornet, J M Sabate, J M Vantelon, J N Vaillant, J P Aucouturier, J P Barbieux, J P Herr, J P Lafargue, J P Lagasse, J P Latrive, J P Plachot, J P Ramain, J P Robin, J P Spano, J Y Douillard, K Beerblock, K Bouhier-Leporrier, K Slimane Fawzi, L Cany, L Chone, L Dahan, L Gasnault, L Rob, L Stefani, L Wander, M Baconnier, M Ben Abdelghani, M Benchalal, M Blasquez, M Carreiro, M Charbit, M Combe, M Duluc, M Fayolle, M Gignoux, M Giovannini, M Glikmanas, M Mabro, M Mignot, M Mornet, M Mousseau, M Mozer, M Pauwels, M Pelletier, M Porneuf, M Ramdani, M Schnee, M Tissot, M Zawadi, M C Clavero-Fabri, M C Gouttebel, M C Kaminsky, M P Galais, N Abdelli, N Barrière, N Bouaria, N Bouarioua, N Delas, N Gérardin, N Hess-Laurens, N Stremsdoerfer, O Berthelet, O Boulat, O Capitain, O Favre, P Amoyal, P Bergerault, P Burtin, P Cassan, P Chatrenet, P Chiappa, P Claudé, P Couzigou, P Feydy, P Follana, P Geoffroy, P Godeau, P Hammel, P Laplaige, P Lehair, P Martin, P Novello, P Pantioni, P Pienkowski, P Pouderoux, P Prost, P Ruszniewski, P Souillac, P Texereau, P Thévenet, P A Haineaux, R Benoit, R Coriat, R Lamy, R Mackiewicz, S Beorchia, S Chaussade, S Hiret, S Jacquot, S Lavau Denes, S Montembault, S Nahon, S Nasca, S Nguyen, S Oddou-Lagraniere, S Pesque-Penaud, S P Fratte, T Chatellier, T Mansourbakht, T Morin, T Walter, V Boige, V Bourgeois, V Derias, V Guérin-Meyer, V Hautefeuille, V Jestin Le Tallec, V Lorgis, V Quentin, V Sebbagh, V Veuillez, X Adhoute, X Coulaud, Y Becouarn, Y Coscas, Y Courouble, Y Le Bricquir, Y Molin, Y Rinaldi, Y H Lam, Z Ladhib

Affiliations

¹ Gastroenterology Department, CHU Saint Louis, APHP, Paris, France; University Paris 7, Sorbonne Paris Cité, Paris, France. Electronic address: thomas.aparicio@aphp.fr.
² Department of Medical Oncology, Gustave Roussy, Université Paris-Saclay, Villejuif, France.
³ Gastroenterology Department, CH La Roche sur Yon, La Roche sur Yon, France.
⁴ Statistics Department, Fédération Francophone de Cancérologie Digestive, Dijon, France; INSERM UMR 1231, Dijon, France.
⁵ Univ. Bourgogne Franche-Comté, INSERM UMR1231, Gastroenterology Department, CHU de Dijon, Dijon, France.
⁶ Gastroenterology Department, CHU Trousseau, Tours, France.
⁷ Oncology Department, CARIO, HPCA, Plérin, France.
⁸ Oncology Department, Institut de Cancérologie de L'Ouest, Saint Herblay, France.
⁹ Gastroenterology Department, CHU Saint Etienne - Hôpital Nord, Saint Priest en Jarez, France.
¹⁰ Gastroenterology Department, Centre Antoine Lacassagne, Nice, France.
¹¹ Gastroenterology Department, Rouen University Hospital, CHU Charles Nicolle, Rouen, France.
¹² Hepato-Gastroenterology and Digestive Oncology Department, CHR La Source, Orléans, France.
¹³ Gastroenterology Department, CHU Hôpital Nord, Marseille, France.
¹⁴ Gastroenterology Department, CH Pasteur, Colmar, France.
¹⁵ Gastroenterology Department, CHU de Nantes, Nantes, France.
¹⁶ Oncology Department, Hôpital Franco-Britanique, Levallois Perret, France.
¹⁷ Digestive Oncology Department, CHU Robert Debré, Reims, France.
¹⁸ Digestive Oncology Department, CHU La Timone, APHM, Aix-Marseille Univ, Marseille, France.

PMID: 29807237
DOI: 10.1016/j.ejca.2018.03.031

Abstract

Background: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in early-stage colorectal cancer (CRC), and low BMI was associated with worse prognosis in metastatic CRC (mCRC). We aimed to assess efficacy outcomes according to BMI.

Patients and methods: A pooled analysis of individual data from 2085 patients enrolled in eight FFCD first-line mCRC trials from 1991 to 2013 was performed. Comparisons were made according to the BMI cut-off: Obese (BMI ≥30), overweight patients (BMI ≥ 25), normal BMI patients (BMI: 18.5-24) and thin patients (BMI <18.5). Interaction tests were performed between BMI effect and sex, age and the addition of antiangiogenics to chemotherapy.

Results: The rate of BMI ≥25 patients was 41.5%, ranging from 37.6% (1991-1999 period) to 41.5% (2000-2006 period) and 44.8% (2007-2013 period). Comparison of overweight patients versus normal BMI range patients revealed a significant improvement of median overall survival (OS) (18.5 versus 16.3 months, HR = 0.88 [0.80-0.98] p = 0.02) and objective response rate (ORR) (42% versus 36% OR = 1.23 [1.01-1.50] p = 0.04) but a comparable median progression-free survival (PFS) (7.8 versus 7.2 months, HR = 0.96 [0.87-1.05] p = 0.35). Subgroup analyses revealed that overweight was significantly associated with better OS in men. OS and PFS were significantly shorter in thin patients.

Conclusion: Overweight patients had a prolonged OS compared with normal weight patients with mCRC. The association of overweight with better OS was only observed in men. The pejorative prognosis of BMI <18.5 was confirmed.

Keywords: Bevacizumab; Colorectal cancer; Overweight; Pooled analysis; Prognostic factor.

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Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials

Collaborators

Affiliations

Overweight is associated to a better prognosis in metastatic colorectal cancer: A pooled analysis of FFCD trials

Authors

Collaborators

Affiliations

Abstract

Publication types

MeSH terms

Substances

LinkOut - more resources

Full Text Sources

Other Literature Sources

Medical