Lorenzo Gherzi, Mathilde Prieto, Antonio Iannelli, Laurent Brouchet, Pierre-Benoit Pagès, Pierre Emmanuel Falcoz, Françoise Le Pimpec Barthes, Pascal Alexandre Thomas, Marcel Dahan, Marco Alifano
{"title":"超越身体质量指数:身高和身高标准化体重对肺癌手术总生存率的影响","authors":"Lorenzo Gherzi, Mathilde Prieto, Antonio Iannelli, Laurent Brouchet, Pierre-Benoit Pagès, Pierre Emmanuel Falcoz, Françoise Le Pimpec Barthes, Pascal Alexandre Thomas, Marcel Dahan, Marco Alifano","doi":"10.1002/jcsm.70049","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Introduction</h3>\n \n <p>Unlike most malignancies, increased adiposity, as expressed by a higher body mass index (BMI), is associated with improved prognosis after lung cancer surgery at the population level. Height, one of the determinants of BMI, is associated with better survival, independent of other confounders, even though BMI is calculated as weight divided by height squared. The association of weight with survival is difficult to assess because, at the individual level, weight is closely linked to height and does not directly reflect adiposity. In this study, we examined the impact of height and weight on overall survival in a large population of patients undergoing upfront surgery for lung cancer.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>We extracted data on all consecutive patients with stage I–IIIA non-small cell lung cancer included in a surgical nationwide dataset over a 16-year period. For each sex, height was categorised in sex-specific quartiles (sH). Sex-specific height-normalised weight (sHNW) was defined as the ratio of an individual's weight to the mean weight of individuals of the same sex and height, and it was categorised into quartiles. Finally, the sum of the category membership (ranging from 1 to 4 according to quartiles) of sH and sHNW was calculated, and the results were categorised into four groups of sH/sHNW. Overall survival (OS) was assessed by Kaplan–Meier, and differences evaluated by log-rank. Cox models were built.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>The study included 50 653 patients. Mean age was 65.61 ± 9.45 and 31.99% were women. sH predicted OS, taller height being protective [crude HRs of second, third, and fourth quartiles vs. first quartile: 0.94 (95% CI 0.91–0.98), 0.89 (0.86–0.92), 0.77 (0.74–0.81); <i>p</i> < 0.0001]. sHNW was also associated with OS, with lower sHNW category being associated with worse outcome and higher sHNW categories being protective [crude HRs of second, third and fourth quartiles vs. first quartile: 0.88 (0.85–0.92), 0.82 (0.79–0.85), 0.85 (0.81–0.88); <i>p</i> < 0.0001]. The four classes of sH/sHNW showed higher differences in prognosis with respective crude HRs of 0.88 (0.84–0.93), 0.76 (0.73–0.80) and 0.70 (0.66–0.74) in the intermediate lower, intermediate higher and higher class as compared with the lower class. Five-year overall survival rates were 58.65% (56.89–60.45), 62.96% (62.15–63.78), 67.71% (67.02–68.41) and 70.12% (68.98–71.26), in the lower, intermediate lower, intermediate higher and higher class, respectively. All Cox models showed that sHNW and sH/sHNW predicted survival independently from common confounders.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Our study demonstrated that sHNW and sH/sHNW are strong prognostic factors of resectable lung cancer. This finding could have both epidemiologic and biological relevance.</p>\n </section>\n </div>","PeriodicalId":48911,"journal":{"name":"Journal of Cachexia Sarcopenia and Muscle","volume":"16 4","pages":""},"PeriodicalIF":9.1000,"publicationDate":"2025-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.70049","citationCount":"0","resultStr":"{\"title\":\"Beyond Body Mass Index: The Impact of Height and Height-Normalised Weight on Overall Survival of Lung Cancer Undergoing Surgery\",\"authors\":\"Lorenzo Gherzi, Mathilde Prieto, Antonio Iannelli, Laurent Brouchet, Pierre-Benoit Pagès, Pierre Emmanuel Falcoz, Françoise Le Pimpec Barthes, Pascal Alexandre Thomas, Marcel Dahan, Marco Alifano\",\"doi\":\"10.1002/jcsm.70049\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Introduction</h3>\\n \\n <p>Unlike most malignancies, increased adiposity, as expressed by a higher body mass index (BMI), is associated with improved prognosis after lung cancer surgery at the population level. Height, one of the determinants of BMI, is associated with better survival, independent of other confounders, even though BMI is calculated as weight divided by height squared. The association of weight with survival is difficult to assess because, at the individual level, weight is closely linked to height and does not directly reflect adiposity. In this study, we examined the impact of height and weight on overall survival in a large population of patients undergoing upfront surgery for lung cancer.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>We extracted data on all consecutive patients with stage I–IIIA non-small cell lung cancer included in a surgical nationwide dataset over a 16-year period. For each sex, height was categorised in sex-specific quartiles (sH). Sex-specific height-normalised weight (sHNW) was defined as the ratio of an individual's weight to the mean weight of individuals of the same sex and height, and it was categorised into quartiles. Finally, the sum of the category membership (ranging from 1 to 4 according to quartiles) of sH and sHNW was calculated, and the results were categorised into four groups of sH/sHNW. Overall survival (OS) was assessed by Kaplan–Meier, and differences evaluated by log-rank. Cox models were built.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>The study included 50 653 patients. Mean age was 65.61 ± 9.45 and 31.99% were women. sH predicted OS, taller height being protective [crude HRs of second, third, and fourth quartiles vs. first quartile: 0.94 (95% CI 0.91–0.98), 0.89 (0.86–0.92), 0.77 (0.74–0.81); <i>p</i> < 0.0001]. sHNW was also associated with OS, with lower sHNW category being associated with worse outcome and higher sHNW categories being protective [crude HRs of second, third and fourth quartiles vs. first quartile: 0.88 (0.85–0.92), 0.82 (0.79–0.85), 0.85 (0.81–0.88); <i>p</i> < 0.0001]. The four classes of sH/sHNW showed higher differences in prognosis with respective crude HRs of 0.88 (0.84–0.93), 0.76 (0.73–0.80) and 0.70 (0.66–0.74) in the intermediate lower, intermediate higher and higher class as compared with the lower class. Five-year overall survival rates were 58.65% (56.89–60.45), 62.96% (62.15–63.78), 67.71% (67.02–68.41) and 70.12% (68.98–71.26), in the lower, intermediate lower, intermediate higher and higher class, respectively. All Cox models showed that sHNW and sH/sHNW predicted survival independently from common confounders.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Our study demonstrated that sHNW and sH/sHNW are strong prognostic factors of resectable lung cancer. This finding could have both epidemiologic and biological relevance.</p>\\n </section>\\n </div>\",\"PeriodicalId\":48911,\"journal\":{\"name\":\"Journal of Cachexia Sarcopenia and Muscle\",\"volume\":\"16 4\",\"pages\":\"\"},\"PeriodicalIF\":9.1000,\"publicationDate\":\"2025-08-18\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jcsm.70049\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Cachexia Sarcopenia and Muscle\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/jcsm.70049\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GERIATRICS & GERONTOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Cachexia Sarcopenia and Muscle","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/jcsm.70049","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GERIATRICS & GERONTOLOGY","Score":null,"Total":0}
Beyond Body Mass Index: The Impact of Height and Height-Normalised Weight on Overall Survival of Lung Cancer Undergoing Surgery
Introduction
Unlike most malignancies, increased adiposity, as expressed by a higher body mass index (BMI), is associated with improved prognosis after lung cancer surgery at the population level. Height, one of the determinants of BMI, is associated with better survival, independent of other confounders, even though BMI is calculated as weight divided by height squared. The association of weight with survival is difficult to assess because, at the individual level, weight is closely linked to height and does not directly reflect adiposity. In this study, we examined the impact of height and weight on overall survival in a large population of patients undergoing upfront surgery for lung cancer.
Methods
We extracted data on all consecutive patients with stage I–IIIA non-small cell lung cancer included in a surgical nationwide dataset over a 16-year period. For each sex, height was categorised in sex-specific quartiles (sH). Sex-specific height-normalised weight (sHNW) was defined as the ratio of an individual's weight to the mean weight of individuals of the same sex and height, and it was categorised into quartiles. Finally, the sum of the category membership (ranging from 1 to 4 according to quartiles) of sH and sHNW was calculated, and the results were categorised into four groups of sH/sHNW. Overall survival (OS) was assessed by Kaplan–Meier, and differences evaluated by log-rank. Cox models were built.
Results
The study included 50 653 patients. Mean age was 65.61 ± 9.45 and 31.99% were women. sH predicted OS, taller height being protective [crude HRs of second, third, and fourth quartiles vs. first quartile: 0.94 (95% CI 0.91–0.98), 0.89 (0.86–0.92), 0.77 (0.74–0.81); p < 0.0001]. sHNW was also associated with OS, with lower sHNW category being associated with worse outcome and higher sHNW categories being protective [crude HRs of second, third and fourth quartiles vs. first quartile: 0.88 (0.85–0.92), 0.82 (0.79–0.85), 0.85 (0.81–0.88); p < 0.0001]. The four classes of sH/sHNW showed higher differences in prognosis with respective crude HRs of 0.88 (0.84–0.93), 0.76 (0.73–0.80) and 0.70 (0.66–0.74) in the intermediate lower, intermediate higher and higher class as compared with the lower class. Five-year overall survival rates were 58.65% (56.89–60.45), 62.96% (62.15–63.78), 67.71% (67.02–68.41) and 70.12% (68.98–71.26), in the lower, intermediate lower, intermediate higher and higher class, respectively. All Cox models showed that sHNW and sH/sHNW predicted survival independently from common confounders.
Conclusions
Our study demonstrated that sHNW and sH/sHNW are strong prognostic factors of resectable lung cancer. This finding could have both epidemiologic and biological relevance.
期刊介绍:
The Journal of Cachexia, Sarcopenia and Muscle is a peer-reviewed international journal dedicated to publishing materials related to cachexia and sarcopenia, as well as body composition and its physiological and pathophysiological changes across the lifespan and in response to various illnesses from all fields of life sciences. The journal aims to provide a reliable resource for professionals interested in related research or involved in the clinical care of affected patients, such as those suffering from AIDS, cancer, chronic heart failure, chronic lung disease, liver cirrhosis, chronic kidney failure, rheumatoid arthritis, or sepsis.