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Body mass index and mortality in lung cancer patients: a systematic review and meta-analysis

European Journal of Clinical Nutrition volume 72, pages 4–17 (2018)Cite this article

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Abstract

Studies examining the relation of body mass index (BMI) and mortality in patients with lung cancer have shown diverse results. We conducted a meta-analysis to investigate the association using all available studies from January 1982 to October 2016. PubMed and EMBASE were searched to identify relevant studies. We calculated the summary hazard ratio (HR) and 95% confidence interval (CI) using random effects model. The dose–response relationship was assessed by random effects meta-regression model. Fifty-five articles from 51 studies involving 3 152 552 subjects (males, 54.8%) were included. The pooled results suggested that on average a high BMI decreased risk of death from lung cancer or all-cause. Each 5 kg/m2 increase in BMI had a 12% lower risk of lung cancer-specific mortality (HR=0.88, 95% CI: 0.75–1.02, P=0.09) and a 14% lower risk of all-cause mortality (HR=0.86, 95% CI: 0.77–0.96, P<0.01). When stratifying by ethnicity, each 5 kg/m2 increase in BMI was associated with 22% and 28% reduction, respectively, in the risk of lung cancer-specific mortality (P<0.01) and all-cause mortality (P<0.01) in Asians, but no association was found in Westerners (P=0.51 and P=0.53, respectively). In conclusion, lung cancer patients with a higher BMI have a longer survival than those with a lower BMI. Considering the significant heterogeneity between included studies, future studies are needed to confirm these findings.

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Acknowledgements

This study was supported by the National Natural Science Foundation of China (No. 81602551 and 81272470) and the Key Research Program for the Social Development of Jiangsu Province, China (No. BE2015718).

Author contributions

SZ and JZ designed the research. JW and SZ analyzed the data. JW, HX, SZ and JT wrote the manuscript. HX, JH, LZ and DW searched database, extracted the data and evaluated the methodological quality of the studies. SZ had primary responsibility for the final content. All authors read and approved the final manuscript.

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  1. J Wang and H Xu: These authors contributed equally to this work.

Authors and Affiliations

  1. Department of General Surgery, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China

    J Wang, D Wang, L Zhu, J Hou & J Tang

  2. Department of General Surgery, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China

    J Wang

  3. Department of Radiation Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China

    H Xu

  4. The First Clinical Medical College, Nanjing University of Traditional Chinese Medicine, Nanjing, China

    S Zhou

  5. Center of Clinical Laboratory Science, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research, Nanjing, China

    J Zhao & S Zhong

  6. Center of Clinical Laboratory Science, Nanjing Medical University Affiliated Cancer Hospital, Nanjing, China

    J Zhao & S Zhong

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Wang, J., Xu, H., Zhou, S. et al. Body mass index and mortality in lung cancer patients: a systematic review and meta-analysis. Eur J Clin Nutr 72, 4–17 (2018). https://doi.org/10.1038/ejcn.2017.70

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