The Association between Abdominal Obesity, Metabolic Syndrome and Survival Outcomes in Patients with Breast Cancer

Document Type : Research Articles

Authors

1 Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada; Dr. Sardjito Hospital, Yogyakarta, Indonesia.

2 Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada; Dr. Sardjito Hospital, Yogyakarta, Indonesia.

3 Division of Endocrinology and Metabolic Disease, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada; Dr. Sardjito Hospital, Yogyakarta, Indonesia.

4 Department of Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada; Dr. Sardjito Hospital, Yogyakarta, Indonesia.

5 Div. Oncology Surgery, Department of Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada; Dr. Sardjito Hospital, Yogyakarta, Indonesia.

Abstract

Background: Obesity and metabolic syndrome (MetS) have been linked to the risk of developing certain cancers. This study aimed to analyze the association between obesity markers, MetS and survival outcomes of patients with breast cancer. Methods: This study retrospectively investigated patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative (HR+/HER2-), nonmetastatic breast cancer diagnosed between January 2010 and December 2019. Data on clinical conditions, body mass index (BMI), waist-to-hip ratio (WHR), MetS, time of metastasis and death were collected. Results: A total of 223 breast cancer patient records were eligible for analysis. Obesity (BMI ≥ 25) was found in 38.1% of cases. Abdominal obesity measured as WHR ≥ 0.85 was found in 48.9%. Metabolic syndrome was detected in 56.1% of patients and was associated with older age (OR = 2.196, p = 0.005), postmenopausal status (OR = 2.585, p = 0.001), obesity (OR = 5.684, p = 0.001) and abdominal obesity (OR = 2.612, p = 0.001). Obesity was not associated with poor disease-free survival (DFS) or overall survival (OS), while abdominal obesity was modestly associated with poor DFS (HR = 1.539, p = 0.083) and OS (HR = 3.117; p = 0.019). Multivariate analysis revealed that WHR ≥ 0.85 was independently associated with unfavorable DFS (HR = 1.907, p = 0.027). Patients with MetS had a similar survival rate to those with normal metabolism. Conclusion: In Indonesian women with HR+/HER2- breast cancers, obesity and MetS were not associated with poor survival outcomes. The abdominal obesity marker (WHR) was more accurate in predicting unfavorable DFS.

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Volume 23, Issue 9
September 2022
Pages 3157-3165
  • Receive Date: 07 May 2022
  • Revise Date: 25 June 2022
  • Accept Date: 04 September 2022
  • First Publish Date: 04 September 2022