Impact of weight change on the prognosis of cancer patients: A multicenter, prospective study

IF 2.6 Q3 NUTRITION & DIETETICS

Clinical nutrition ESPEN Pub Date : 2025-09-13 DOI:10.1016/j.clnesp.2025.09.011

Gege Zhang , Chuying Zhang , Saba Fida , Zengqing Guo , Jiuwei Cui , Wei Li , Min Weng , Kunhua Wang , Suyi Li , Hanping Shi , Hongxia Xu , Chunhua Song

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引用次数: 0

Abstract

Background & aims

Weight loss may increase the risk of death from cancer; however, research findings are mixed, and little is known about the effects of weight gain. We evaluated the association between weight change in the 2 years after diagnosis and the risk of all-cause mortality in Chinese adult patients with cancer.

Methods

This prospective cohort study included 2,795 adults with cancer. The association between weight change and all-cause mortality of cancer patients was explored using Cox proportional hazards model and restricted cubic spline model. Subgroup analysis and interaction terms were used to explore whether weight change was associated with certain variables. Then, 2,067 subjects who did not experience weight gain at the first follow-up visit were used to test the association between all-cause mortality and weight change between baseline and the first follow-up visits and between the first and last follow-up visits.

Results

After adjusting for confounding factors, weight loss was linked to a higher risk of all-cause mortality: the hazard ratios for the severe and moderate weight loss groups were 2.03 (95 % CI: 1.62–2.55) and 1.40 (95 % CI: 1.09–1.80), respectively. When assessed by gender, the overall trends were consistent with those of the general population, but the association between weight loss and poor prognosis was more pronounced in male patients. There was no significant association between weight gain and the risk of all-cause mortality. Regardless of subsequent weight regain or weight maintenance and loss, cancer patients who experienced severe weight loss within two years were associated with an increased risk of mortality.

Conclusion

Weight loss was linked to an increased risk of all-cause mortality in cancer patients, particularly in males. Regardless of subsequent weight fluctuations, severe weight loss remained associated with an increased risk of all-cause mortality.

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体重变化对癌症患者预后的影响：一项多中心前瞻性研究

背景与目的：减肥可能会增加癌症死亡的风险；然而，研究结果好坏参半，人们对体重增加的影响知之甚少。我们评估了中国成年癌症患者诊断后2年内体重变化与全因死亡风险之间的关系。方法：这项前瞻性队列研究纳入了2795名成年癌症患者。采用Cox比例风险模型和限制三次样条模型探讨体重变化与癌症患者全因死亡率的关系。使用亚组分析和相互作用项来探讨体重变化是否与某些变量相关。然后，2067名在第一次随访中没有体重增加的受试者被用来测试基线和第一次随访之间以及第一次和最后一次随访之间的全因死亡率和体重变化之间的关系。结果：在调整混杂因素后，体重减轻与全因死亡率的高风险相关：重度和中度体重减轻组的风险比分别为2.03 （95% CI: 1.62-2.55）和1.40 （95% CI: 1.09-1.80）。当按性别评估时，总体趋势与一般人群一致，但体重减轻与预后不良之间的关联在男性患者中更为明显。体重增加和全因死亡率之间没有明显的联系。无论随后的体重恢复、体重维持或体重减轻，在两年内体重严重减轻的癌症患者死亡风险增加。结论：体重减轻与癌症患者全因死亡风险增加有关，尤其是男性。无论随后的体重波动如何，严重的体重减轻仍然与全因死亡率的风险增加有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical nutrition ESPEN NUTRITION & DIETETICS-

CiteScore

4.90

自引率

3.30%

发文量

512

期刊介绍： Clinical Nutrition ESPEN is an electronic-only journal and is an official publication of the European Society for Clinical Nutrition and Metabolism (ESPEN). Nutrition and nutritional care have gained wide clinical and scientific interest during the past decades. The increasing knowledge of metabolic disturbances and nutritional assessment in chronic and acute diseases has stimulated rapid advances in design, development and clinical application of nutritional support. The aims of ESPEN are to encourage the rapid diffusion of knowledge and its application in the field of clinical nutrition and metabolism. Published bimonthly, Clinical Nutrition ESPEN focuses on publishing articles on the relationship between nutrition and disease in the setting of basic science and clinical practice. Clinical Nutrition ESPEN is available to all members of ESPEN and to all subscribers of Clinical Nutrition.