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Cancer Causes & Control
Published in: Cancer Causes & Control 11/2014

01-11-2014 | Original paper

Association of obesity and overweight with overall survival in colorectal cancer patients: a meta-analysis of 29 studies

Authors: Shuangjie Wu, Jun Liu, Xinhai Wang, Mengjun Li, Yu Gan, Yifan Tang

Published in: Cancer Causes & Control | Issue 11/2014

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Abstract

Purpose

Previous studies that assessed the relationship between obesity, overweight, and survival in colorectal cancer (CRC) have provided conflicting results. Therefore, we quantitatively summarized existing evidence to estimate the association between obesity/overweight and overall survival (OS) in CRC patients and explored potentially important sources of variability.

Methods

Eligible studies were identified via PubMed and EMBASE searches. The summary hazard ratio (sHR) was estimated using a fixed-effects or random-effects model according to the heterogeneity between the studies. Meta-regression and subgroup analyses were performed to explore potential sources of heterogeneity.

Results

A total of 29 eligible studies, with 51,303 CRC patients, were finally included. The overall analysis showed worse OS among obese patients [sHR 1.10, 95 % confidence intervals (CI) 1.06–1.15], but not among overweight patients (sHR 0.92, 95 % CI 0.86–1.00), than in normal-weight patients. Considerable heterogeneity was observed across studies, which was primarily attributed to the timing of body mass index (BMI) assessment (meta-regression p < 0.05). The association between obesity and worse OS was strengthened when BMI was assessed before diagnosis (sHR 1.30, 95 % CI, 1.17–1.44). Conversely, post-diagnostic, in particular post-treatment, overweight was associated with a better OS (sHR 0.79, 95 % CI 0.70–0.91). Other factors, including gender, geographic location, and stage, may also modify the prognostic value of obesity or overweight.

Conclusions

Obese but not overweight patients appear to have worse OS than normal-weight patients with CRC. The associations of obesity and overweight with OS in CRC patients majorly depend upon the timing of BMI assessment.
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Metadata
Title
Association of obesity and overweight with overall survival in colorectal cancer patients: a meta-analysis of 29 studies
Authors
Shuangjie Wu
Jun Liu
Xinhai Wang
Mengjun Li
Yu Gan
Yifan Tang
Publication date
01-11-2014
Publisher
Springer International Publishing
Published in
Cancer Causes & Control / Issue 11/2014
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-014-0450-y

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