Table 3. Studies describing the association between lung cancer outcomes and various obesity measures.
| Study | Sample size | Obesity measure | Results | Comment |
|---|---|---|---|---|
| Barbi et al., 2021 (54) | 513 | BMI, VFI | High VFI associated with worse OS (HR =1.84, 95% CI: 1.21–2.81) and worse RFS (HR =1.82, 95% CI: 1.06–3.11) | Supported by immunological data using mouse lung cancer models |
| Jiang et al., 2021 (50) | 20,937 | BMI | Obese (HR =0.88, 95% CI: 0.83–0.92) and overweight (HR =0.89, 95% CI: 0.85–0.93) patients associated with better OS Underweight patients associated with worse OS (HR =1.58, 95% CI: 1.43–1.72) | OS is inversely associated with BMI but varies by sex, race, and smoking history |
| Lee et al., 2018 (51) | 173 | BMI | BMI ≥23 kg/m2 associated with better OS (HR =0.45, 95% CI: 0.31–0.79) | Association persisted after adjusting for stage, age, gender, smoking history and ECOG PS |
| Lee et al., 2018 (55) | 171 | SAT, VAT volume | Improved PFS in patients with high SAT volume (HR =0.54, 95% CI: 0.3–0.9) | – |
| Minami et al., 2020 (56) | 128 | BMI, IMAC, PMI, VSR | BMI, IMAC, PMI, and VSR did not predict OS on multivariable analysis | – |
| Morel et al., 2018 (53) | 7,051 | BMI, pre-diagnosis weight loss | Worse OS with increase in patients’ pre-diagnosis weight loss: HR =1.17, 1.23, and 1.46 with pre-diagnosis weight loss of 0–5, 5–10, and >10 kg respectively | Pre-diagnosis weight loss eliminates BMI from the multivariable regression model |
| Nam et al., 2019 (57) | 356 | BMI | NSCLC patients with low BMI and high BMD have a higher risk of brain metastasis (HR =2.03, 95% CI: 1.21–3.4) | – |
| Oruc et al., 2022 (58) | 200 | BMI, BFM | BFM >22% had improved OS compared to those with BFM ≤22% (P=0.01) | – |
| Sakai et al., 2021 (59) | CRC: 74, NSCLC: 53 | FFMI, FMI, SM FF | Increased length of hospital stay for NSCLC patients was associated with sarcopenia status (P=0.027) and increased SM FF% (P=0.035) | – |
| Shepshelovich et al., 2019 (52) | NSCLC: 25,340, SCLC: 2,787 | BMI, BMI change | Improved OS with increase in BMI at diagnosis (HR =0.92, 95% CI: 0.91–0.94) | BMI decrease in young adulthood associated with worse survival |
| Wang et al., 2018 (9) | 3,152,552 | BMI | 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<0.01) | BMI was inversely associated with lung cancer-specific and all-cause mortality in Asians but not in Westerners |
| Yendamuri et al., 2019 (60) | 639 | BMI | Better OS (HR =0.52) and DSS (HR =0.21) with metformin use in high BMI patients with stage 1 NSCLC | Metformin use improve outcomes only in those with high BMI. Supported by immunological data |
| Yuan et al., 2022 (61) | 7,547 | BMI, post-diagnosis BMI change | Moderate (0.5–2: HR =2.45, 95% CI: 2.25–2.67), and large (>2: HR =4.65, 95% CI: 4.15–2.45) post-diagnosis decreases in BMI were associated with worse OS | – |
BMI, body mass index; VFI, visceral fat index; OS, overall survival; HR, hazard ratio; CI, confidence interval; RFS, recurrence free survival; ECOG PS, Eastern Cooperative Oncology Group Performance Score; SAT, subcutaneous adipose tissue; VAT, visceral adipose tissue; PFS, progression free survival; IMAC, intramuscular adipose content; PMI, psoas muscle index; VSR, visceral to subcutaneous ration; NSCLC, non-small cell lung cancer; BMD, bone mineral density; BFM, body fat mass; CRC, colorectal cancer; FFMI, fat free mass index; FMI, fat mass index; SM FF, skeletal muscle fat fraction; SCLC, small cell lung cancer; DSS, disease specific survival.