Cancer Research and Treatment

Original Articles

The Impact of Obesity on Treatment Outcomes in Patients with Hormone Receptor-Positive HER2-Negative Metastatic Breast Cancer Receiving CDK 4/6 Inhibitors: Yoo Bin Jung, Hee Kyung Ahn, Hyun-Young Shin, Ji Hyung Hong, Chai Hong Rim; Received January 25, 2025 Accepted April 13, 2025 Published online April 15, 2025; DOI: https://doi.org/10.4143/crt.2025.110 [Accepted]

Abstract PDF: Purpose
Guidelines from the aromatase inhibitor era for early breast cancer (EBC) treatment recommend maintaining a body mass index (BMI) below 25. In the current era of CDK 4/6 inhibitors, now standard in metastatic breast cancer (MBC), limited data exist on treatment outcomes in obese patients. This study investigates how adiposity affects the treatment outcome of CDK 4/6 inhibitors in patients with hormone receptor (HR)-positive, HER2-negative MBC.
Materials and Methods
We searched PubMed, MEDLINE, and Embase databases, assessing efficacy outcomes such as progression-free survival (PFS) based on obesity markers, including BMI and visceral adipose tissue (VAT) index.
Results
Twelve studies were reviewed, with seven studies and 1,812 patients included in a pooled meta-analysis. Among patients with BMI ≥25, modest improvement in PFS was observed, with a pooled hazard ratio (HR) of 0.944 (95% CI, 0.909-0.980; p = 0.003). Besides, add-on analysis using VAT to define obesity revealed a notable PFS improvement, with a pooled HR of 0.452 (95% CI, 0.256-0.798; p = 0.006).
Conclusion
While BMI-defined obesity showed slight PFS improvement with CDK 4/6 inhibitors and endocrine therapy, using VAT to define obesity revealed significant PFS gains. This highlights the need for further research on biomarker to clarify the role of adiposity in MBC, which may differ from its impact in EBC.

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General

Adherence to Cancer Prevention Guidelines and Cancer Incidence and Mortality: A Population-Based Cohort Study: Jin-Kyoung Oh, Minji Han, Byungmi Kim, Eun Young Park; Cancer Res Treat. 2023;55(1):15-27. Published online March 22, 2022; DOI: https://doi.org/10.4143/crt.2021.1031

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Purpose
This study aimed to estimate the risk of cancer incidence and mortality according to adherence to lifestyle-related cancer prevention guidelines.
Materials and Methods
Men and women who participated in the general health screening program in 2002 and 2003 provided by the National Health Insurance Service were included (n=8,325,492). Self-reported smoking, alcohol consumption, and physical activity habits and directly measured body mass index were collected. The participants were followed up until the date of cancer onset or death or 31 December 2018. The Cox proportional hazard model was used to evaluate the hazard ratio (HR) for cancer incidence and mortality according to different combinations of lifestyle behaviors.
Results
Only 6% of men and 15% of women engaged in healthy behavior at baseline, such as not smoking, not drinking alcohol, being moderately or highly physically active, and within a normal body mass index range. Compared to the best combination of healthy lifestyle behaviors, the weak and moderate associations with increased all cancer incidence (HR < 1.7) and mortality (HR < 2.5) were observed in those with heavy alcohol consumption and in former or current smokers. HRs of cancer mortality were significantly increased among current smokers in most combinations.
Conclusion
Compared to full adherence to cancer prevention recommendations, unhealthy behaviors increase cancer risk. As few people meet these recommendations, there is a great opportunity for cancer prevention.

Citations

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A comparative study of health behaviors in adult male cancer survivors and the general male population in Korea: from the Korea national health and nutrition examination survey VII-VIII (2016–2021)
Hyein Jung, Yoonjoo Choi, Byungmi Kim
Supportive Care in Cancer.2025;[Epub] CrossRef
Cancer risk according to lifestyle risk score trajectories: a population-based cohort study
Thi Minh Thu Khong, Thi Tra Bui, Hee-Yeon Kang, Eunjung Park, Moran Ki, Yoon-Jung Choi, Byungmi Kim, Jin-Kyoung Oh
BJC Reports.2025;[Epub] CrossRef
Increased risk of cardiovascular disease among kidney cancer survivors: a nationwide population-based cohort study
Minji Jung, Eunjung Choo, Shufeng Li, Zhengyi Deng, Jinhui Li, Mingyi Li, Satvir Basran, Sukhyang Lee, Marvin E. Langston, Benjamin I. Chung
Frontiers in Oncology.2024;[Epub] CrossRef
Cancer survivors’ adherence to the American cancer society and American institute of cancer research dietary guidelines in Lebanon
Jana Jabbour, Remie El Helou, Ruba Hadla, Riwa Azar, Maria Mezher, Farah Naja, Sally Temraz
BMC Public Health.2024;[Epub] CrossRef
Longitudinal Trends of Comorbidities and Survival Among Kidney Cancer Patients in Asian Population
Minji Jung, Eunjung Choo, Jinhui Li, Zhengyi Deng, Marvin E. Langston, Sukhyang Lee, Benjamin I. Chung
Cancer Medicine.2024;[Epub] CrossRef
Combinations of lifestyle behaviors and cancer risk among Korean adults
Ngoc Minh Luu, Thi Tra Bui, Thi Phuong Thao Tran, Thi Huyen Trang Nguyen, Jin-Kyoung Oh
Scientific Reports.2023;[Epub] CrossRef
Individual and joint effect of socioeconomic status and lifestyle factors on cancer in Korea
Chi Lan Tran, Kui Son Choi, Sun‐Young Kim, Jin‐Kyoung Oh
Cancer Medicine.2023; 12(16): 17389. CrossRef
Tumorkachexie: die Bedeutung von Ernährung und Bewegung in der Onkologie
Yurdagül Zopf, Hans Joachim Herrmann, Dejan Reljic, Luisa Marie Hardt
Zeitschrift für Komplementärmedizin.2023; 15(06): 12. CrossRef
Adherence to the World Cancer Research Fund/American Institute for Cancer Research and Korean Cancer Prevention Guidelines and cancer risk: a prospective cohort study from the Health Examinees-Gem study
Jeeyoo Lee, Aesun Shin, Woo-Kyoung Shin, Ji-Yeob Choi, Daehee Kang, Jong-Koo Lee
Epidemiology and Health.2023; 45: e2023070. CrossRef

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Endocrine Cancer

Association among Body Mass Index, Genetic Variants of FTO, and Thyroid Cancer Risk: A Hospital-Based Case-Control Study of the Cancer Screenee Cohort in Korea: Tung Hoang, Dayoung Song, Jeonghee Lee, Eun Kyung Lee, Yul Hwangbo, Jeongseon Kim; Cancer Res Treat. 2021;53(3):857-873. Published online December 7, 2020; DOI: https://doi.org/10.4143/crt.2020.720

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Purpose
Obesity has been determined to be associated with fat mass and obesity-associated (FTO) gene and thyroid cancer risk. However, the effect of combined interactions between obesity and the FTO gene on thyroid cancer needs further investigation. This study aimed to examine whether interactions between body mass index (BMI) and the FTO gene are associated with an increased risk of thyroid cancer.
Materials and Methods
A total of 705 thyroid cancer cases and 705 sex- and age-matched normal controls were selected from the Cancer Screenee Cohort in National Cancer Center, Korea. A conditional logistic regression model was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for the measure of associations and the combined effect of BMI and FTO gene on thyroid cancer.
Results
BMI was associated with an increased risk of thyroid cancer in subclasses of overweight (23-24.9 kg/m²; adjusted OR, 1.50; 95% CI, 1.12 to 2.00) and obese (≥ 25 kg/m²) (adjusted OR, 1.62; 95% CI, 1.23 to 2.14). There were positive associations between the FTO genetic variants rs8047395 and rs8044769 and an increased risk of thyroid cancer. Additionally, the combination of BMI subclasses and FTO gene variants was significantly associated with thyroid cancer risk in the codominant (rs17817288), dominant (rs9937053, rs12149832, rs1861867, and rs7195539), and recessive (rs17817288 and rs8044769) models.
Conclusion
Findings from this study identified the effects of BMI on thyroid cancer risk among individuals carrying rs17817288, rs9937053, rs12149832, rs1861867, rs7195539, and rs8044769, whereas the effects of BMI may be modified according to individual characteristics of other FTO variants.

Citations

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Polymorphisms in the FTO Gene and Their Association With Cancer Risk: A Comprehensive Review and Meta‐Analysis
Fengran Guo, Yilong Gao, Hu Wang, Pengfei Zhou, Yanping Zhang, Zhihai Teng, Yaxuan Wang, Zhenwei Han
Cancer Reports.2025;[Epub] CrossRef
Exploring the Link between BMI and Aggressive Histopathological Subtypes in Differentiated Thyroid Carcinoma—Insights from a Multicentre Retrospective Study
Giacomo Di Filippo, Gian Luigi Canu, Giovanni Lazzari, Dorin Serbusca, Eleonora Morelli, Paolo Brazzarola, Leonardo Rossi, Benard Gjeloshi, Mariangela Caradonna, George Kotsovolis, Ioannis Pliakos, Efthymios Poulios, Theodosios Papavramidis, Federico Capp
Cancers.2024; 16(7): 1429. CrossRef
Analysis of Body Mass Index and Clinicopathological Factors in Patients with Papillary Thyroid Carcinoma
Wei Yan, Xue Luo, Qing-Jun Gao, Bing-Feng Chen, Hui Ye
Diabetes, Metabolic Syndrome and Obesity.2024; Volume 17: 2013. CrossRef
Human adipose-derived stem cells promote migration of papillary thyroid cancer cell via leptin pathway
Bo-Tao Zhang, Ying Li, Qi-Lan Jiang, Rui Jiang, Yang Zeng, Jun Jiang
Annals of Medicine.2024;[Epub] CrossRef
The association of obesity with thyroid carcinoma risk
Xiao‐Ni Ma, Cheng‐Xu Ma, Li‐Jie Hou, Song‐Bo Fu
Cancer Medicine.2022; 11(4): 1136. CrossRef
Seaweed and Iodine Intakes and SLC5A5 rs77277498 in Relation to Thyroid Cancer
Tung Hoang, Eun Kyung Lee, Jeonghee Lee, Yul Hwangbo, Jeongseon Kim
Endocrinology and Metabolism.2022; 37(3): 513. CrossRef
Low-Level Environmental Mercury Exposure and Thyroid Cancer Risk Among Residents Living Near National Industrial Complexes in South Korea: A Population-Based Cohort Study
Seyoung Kim, Sang-Hwan Song, Chul-Woo Lee, Jung-Taek Kwon, Eun Young Park, Jin-Kyoung Oh, Hyun-Jin Kim, Eunjung Park, Byungmi Kim
Thyroid.2022; 32(9): 1118. CrossRef
Association between Obesity Indexes and Thyroid Cancer Risk in Korean Women: Nested Case–Control Study
Yoonyoung Jang, Taehwa Kim, Brian H. S. Kim, Boyoung Park
Cancers.2022; 14(19): 4712. CrossRef
FTO Gene Polymorphisms Contribute to the Predisposition and Radiotherapy Efficiency of Nasopharyngeal Carcinoma
Feng Xiao, Jianrong Zhou
Pharmacogenomics and Personalized Medicine.2021; Volume 14: 1239. CrossRef

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Television Viewing Time and Breast Cancer Incidence for Japanese Premenopausal and Postmenopausal Women: The JACC Study: Jinhong Cao, Ehab Salah Eshak, Keyang Liu, Isao Muraki, Renzhe Cui, Hiroyasu Iso, Akiko Tamakoshi, JACC Study Group; Cancer Res Treat. 2019;51(4):1509-1517. Published online March 21, 2019; DOI: https://doi.org/10.4143/crt.2018.705

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Purpose
The evidence on effects of TV viewing time among premenopausal and postmenopausal women for breast cancer risk remains controversial and limited.
Materials and Methods
A prospective study encompassing 33,276 (17,568 premenopausal, and 15,708 postmenopausal) women aged 40-79 years in whom TV viewing time, menstrual, and reproductive histories were determined by a self-administered questionnaire. The follow-up was from 1988 to 2009 and hazard ratios (HRs) with 95% confidence intervals (CIs) of breast cancer incidence were calculated for longer TV viewing time in reference to shorter TV viewing time by Cox proportional hazard models.
Results
During 16.8-year median follow-up, we found positive associations between TV viewing time and breast cancer incidence with a borderline significant trend among total women and a significant trend among postmenopausal women. Among total women, the multivariable HRs (95% CIs) for risk of breast cancer in reference to < 1.5 hr/day of TV viewing time were 0.89 (0.59-1.34) for 1.5 to < 3.0 hr/day, 1.19 (0.82-1.74) for 3.0 to < 4.5 hr/day, and 1.45 (0.91-2.32) for ≥ 4.5 hr/day (p for trend=0.053) and among postmenopausal women, the corresponding risk estimates were 1.10 (0.42-2.88), 2.54 (1.11-5.80), and 2.37 (0.92-6.10) (p for trend=0.009), respectively.
Conclusion
Prolonged TV viewing time was associated with increased risk of breast cancer, especially among postmenopausal women.

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METTL3 regulates FAM83D m6A modification to accelerate tumorigenesis of triple-negative breast cancer via the Wnt/β-catenin pathway
Xiaodong Yu, Yaxun Li, Fanshuang Kong, Qun Xu
Toxicology in Vitro.2024; 95: 105746. CrossRef
Risk Factors for Female Breast Cancer: A Population Cohort Study
Yu-Chiao Wang, Ching-Hung Lin, Shih-Pei Huang, Mingchih Chen, Tian-Shyug Lee
Cancers.2022; 14(3): 788. CrossRef
Sedentary behavior and risk of breast cancer: a dose–response meta-analysis from prospective studies
Feifei Chong, Yanli Wang, Mengmeng Song, Qiuyu Sun, Weihong Xie, Chunhua Song
Breast Cancer.2021; 28(1): 48. CrossRef
Television Viewing Time and the Risk of Colorectal Cancer Mortality among Japanese Population: The JACC Study
Yuting Li, Ehab S. Eshak, Renzhe Cui, Kokoro Shirai, Keyang Liu, Hiroyasu Iso, Satoyo Ikehara, Akiko Tamakoshi, Shigekazu Ukawa
Cancer Research and Treatment.2021; 53(2): 497. CrossRef
Association of job category and occupational activity with breast cancer incidence in Japanese female workers: the JACC study
Gita Nirmala Sari, Ehab Salah Eshak, Kokoro Shirai, Yoshihisa Fujino, Akiko Tamakoshi, Hiroyasu Iso
BMC Public Health.2020;[Epub] CrossRef
Identification of NUF2 and FAM83D as potential biomarkers in triple-negative breast cancer
Xiuming Zhai, Zhaowei Yang, Xiji Liu, Zihe Dong, Dandan Zhou
PeerJ.2020; 8: e9975. CrossRef

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Association between Body Mass Index and Gastric Cancer Risk According to Effect Modification by Helicobacter pylori Infection: Jieun Jang, Eun-Jung Cho, Yunji Hwang, Elisabete Weiderpass, Choonghyun Ahn, Jeoungbin Choi, Soung-Hoon Chang, Hai-Rim Shin, Min Kyung Lim, Keun-Young Yoo, Sue K. Park; Cancer Res Treat. 2019;51(3):1107-1116. Published online November 21, 2018; DOI: https://doi.org/10.4143/crt.2018.182

Abstract PDF Supplementary Material PubReader ePub

Purpose
Few studies investigated roles of body mass index (BMI) on gastric cancer (GC) risk according to Helicobacter pylori infection status. This study was conducted to evaluate associations between BMI and GC risk with consideration of H. pylori infection information.
Materials and Methods
We performed a case-cohort study (n=2,458) that consists of a subcohort, (n=2,193 including 67 GC incident cases) randomly selected from the Korean Multicenter Cancer Cohort (KMCC) and 265 incident GC cases outside of the subcohort. H. pylori infection was assessed using an immunoblot assay. GC risk according to BMI was evaluated by calculating hazard ratios (HRs) and their 95% confidence intervals (95% CIs) using weighted Cox hazard regression model.
Results
Increased GC risk in lower BMI group (< 23 kg/m²) with marginal significance, (HR, 1.32; 95% CI, 0.98 to 1.77) compared to the reference group (BMI of 23-24.9 kg/m²) was observed. In the H. pylori non-infection, both lower (< 23 kg/m²) and higher BMI (≥ 25 kg/m²) showed non-significantly increased GC risk (HR, 10.82; 95% CI, 1.25 to 93.60 and HR, 11.33; 95% CI, 1.13 to 113.66, respectively). However, these U-shaped associations between BMI and GC risk were not observed in the group who had ever been infected by H. pylori.
Conclusion
This study suggests the U-shaped associations between BMI and GC risk, especially in subjects who had never been infected by H. pylori.

Citations

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The Influence of Metabolic Syndrome on the Development of Gastrointestinal Malignant Tumors—A Review
Vesna Brzački, Andrija Rančić, Snežana Tešić Rajković, Ivan Nagorni, Marko Stamenković, Elena Stanković, Nikola Milutinović, Aleksandar Vukadinović
Medicina.2025; 61(6): 1025. CrossRef
Ethnic-specific associations between body mass index and gastric cancer: a Mendelian randomization study in European and Korean populations
Sangjun Lee, Sue K. Park
Gastric Cancer.2024; 27(1): 19. CrossRef
Cross-phenotype association analysis of gastric cancer: in-silico functional annotation based on the disease–gene network
Sangjun Lee, Han-Kwang Yang, Hyuk-Joon Lee, Do Joong Park, Seong-Ho Kong, Sue K. Park
Gastric Cancer.2023; 26(4): 517. CrossRef
Association between metabolic syndrome and gastric cancer risk: results from the Health Examinees Study
Dan Huang, Woo-Kyoung Shin, Katherine De la Torre, Hwi-Won Lee, Sukhong Min, Aesun Shin, Jong-Koo Lee, Daehee Kang
Gastric Cancer.2023; 26(4): 481. CrossRef
Cancer Progress and Priorities: Gastric Cancer
Priya Alagesan, Jessica C. Goodwin, Katherine S. Garman, Meira Epplein
Cancer Epidemiology, Biomarkers & Prevention.2023; 32(4): 473. CrossRef
Obesity at early adulthood increases risk of gastric cancer from the Health Examinees-Gem (HEXA-G) study
Hwi-Won Lee, Dan Huang, Woo-Kyoung Shin, Katherine de la Torre, Jae Jeong Yang, Minkyo Song, Aesun Shin, Jong-koo Lee, Daehee Kang, Shengxu Li
PLOS ONE.2022; 17(2): e0260826. CrossRef
Association between Body Mass Index and Risk of Gastric Cancer by Anatomic and Histologic Subtypes in Over 500,000 East and Southeast Asian Cohort Participants
Jieun Jang, Sangjun Lee, Kwang-Pil Ko, Sarah K. Abe, Md. Shafiur Rahman, Eiko Saito, Md. Rashedul Islam, Norie Sawada, Xiao-Ou Shu, Woon-Puay Koh, Atsuko Sadakane, Ichiro Tsuji, Jeongseon Kim, Isao Oze, Chisato Nagata, Shoichiro Tsugane, Hui Cai, Jian-Min
Cancer Epidemiology, Biomarkers & Prevention.2022; 31(9): 1727. CrossRef
Impact of a Fermented High-Fiber Rye Diet on Helicobacter pylori and Cardio-Metabolic Risk Factors: A Randomized Controlled Trial Among Helicobacter pylori-Positive Chinese Adults
Kun Xue, Yuwei Liu, Kia Nøhr Iversen, Mohsen Mazidi, Zheng Qu, Chenglin Dong, Tayi Jin, Göran Hallmans, Per Åman, Anders Johansson, Gengsheng He, Rikard Landberg
Frontiers in Nutrition.2021;[Epub] CrossRef
Current therapeutic options for gastric adenocarcinoma
C.R. Akshatha, Smitha Bhat, R. Sindhu, Dharini Shashank, Sarana Rose Sommano, Wanaporn Tapingkae, Ratchadawan Cheewangkoon, Shashanka K. Prasad
Saudi Journal of Biological Sciences.2021; 28(9): 5371. CrossRef
The U‐shaped association between body mass index and gastric cancer risk in the Helicobacter pylori Biomarker Cohort Consortium: A nested case–control study from eight East Asian cohort studies
Jieun Jang, Tianyi Wang, Hui Cai, Fei Ye, Gwen Murphy, Taichi Shimazu, Philip R Taylor, You‐Lin Qiao, Keun‐Young Yoo, Sun Ha Jee, Jeongseon Kim, Sheau‐Chiann Chen, Christian C Abnet, Shoichiro Tsugane, Wei Zheng, Xiao‐Ou Shu, Michael Pawlita, Sue K. Park,
International Journal of Cancer.2020; 147(3): 777. CrossRef

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The Health Burden of Cancer Attributable to Obesity in Korea: A Population-Based Cohort Study: Joo Eun Lee, Chung Mo Nam, Sang Gyu Lee, Sohee Park, Tae Hyun Kim, Eun-Cheol Park; Cancer Res Treat. 2019;51(3):933-940. Published online October 4, 2018; DOI: https://doi.org/10.4143/crt.2018.301

Abstract PDF Supplementary Material PubReader ePub

Purpose
Considering the health impact of obesity and cancer, it is important to estimate the burden of cancer attributable to high body mass index (BMI). Therefore, the present study attempts to measure the health burden of cancer attributable to excess BMI, according to cancer sites.
Materials and Methods
The present study used nationwide medical check-up sample cohort data (2002-2015). The study subjects were 496,390 individuals (268,944 men and 227,446 women). We first calculated hazard ratio (HR) in order to evaluate the effect of excess BMI on cancer incidence and mortality. Then, the adjusted HR values and the prevalence of excess BMI were used to calculate the population attributable risk. This study also used the Global Burden of Disease method, to examine the health burden of obesity-related cancers attributable to obesity.
Results
The highest disability-adjusted life year (DALY) values attributable to overweight and obesity in men were shown in liver cancer, colorectal cancer, and gallbladder cancer. Among women, colorectal, ovarian, and breast (postmenopausal) cancers had the highest DALYs values attributable to overweight and obesity. Approximately 8.0% and 12.5% of cancer health burden (as measured by DALY values) among obesity-related cancers in men and women, respectively, can be prevented.
Conclusions
Obesity has added to the health burden of cancer. By measuring the proportion of cancer burden attributable to excess BMI, the current findings provide support for the importance of properly allocating healthcare resources and for developing cancer prevention strategies to reduce the future burden of cancer.

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Population attributable fractions of modifiable cancer risk factors in Korea: A systematic review
Mi Ah Han, Seo‐Hee Kim, Eu Chang Hwang, Jae Hung Jung, Sun Mi Park
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Cancers attributable to overweight and obesity in Italy
Matteo Di Maso, Claudio Pelucchi, Giulia Collatuzzo, Gianfranco Alicandro, Matteo Malvezzi, Fabio Parazzini, Eva Negri, Paolo Boffetta, Carlo La Vecchia, Federica Turati
Cancer Epidemiology.2023; 87: 102468. CrossRef
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Impact of Body Mass Index on the Quality of Life after Total Gastrectomy for Gastric Cancer: Ki Bum Park, Ji Yeon Park, Seung Soo Lee, Oh Kyoung Kwon, Ho Young Chung, Wansik Yu; Cancer Res Treat. 2018;50(3):852-860. Published online September 13, 2017; DOI: https://doi.org/10.4143/crt.2017.080

Abstract PDF PubReader ePub

Purpose
We evaluated the impact of postoperative body mass index (BMI) shifts on the quality of life (QoL) following total gastrectomy in patients with gastric cancer.
Materials and Methods
QoL data collected from the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ)-C30 and QLQ-STO22 questionnaires were obtained from 417 patients preoperatively and 1 year after surgery. Patients were divided into two groups based on changes in BMI: group 1 comprised patientswhose BMIrange category dropped, and group 2 included patients who maintained or rose to a higher category compared to their preoperative BMI category.
Results
There were 276 patients in group 1 and 141 in group 2. QoLs with respect to the global health status and functional scales were not significantly different between the groups 1 year after surgery. However, there were significantly greater decreases in QoL in group 1 due to gastrointestinal symptoms, such as nausea and vomiting (p=0.008), appetite loss (p=0.001), and constipation (p=0.038). Of the QLQ-STO22 parameters, dysphagia (p=0.013), pain (p=0.012), reflux symptoms (p=0.017), eating restrictions (p=0.007), taste (p=0.009), and body image (p=0.009) were associated with significantly worse QoL in group 1 than in group 2 1 year after surgery.
Conclusion
Patients have significantly different QoLs depending on the BMI shift after total gastrectomy. Efforts to reduce the gap in QoL should include intensive nutritional support and restoration of dietary behaviors. Appropriate clinical and institutional approaches, plus active medical interventions, are required for maintaining patients’ BMIs after surgery.

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Wan‐Jin Zhang, Xu‐Yun Huang, Bin Lin, Wen‐Cai Zheng, Zhi‐Bin Ke, Xiao‐Dan Lin, Jia‐Yin Chen, Hai Cai, Yun‐Zhi Lin, Ye‐Hui Chen, Qing‐Shui Zheng, Yong Wei, Xue‐Yi Xue, Xiao‐Dong Li, Ning Xu
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Jianhong Yu, Zaozao Wang, Hong Yang, Chenghai Zhang, Jiadi Xing, Ming Cui, Hui Liu, Yu Wu, Xiangqian Su
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Pawel Bryniarski, Magdalena Bryniarska, Maciej Jezioro, Daniel Andrysiak, Iwona Filipczak-Bryniarska
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Hui-Ying Yang, Yun-Hsiang Lee, Jin-Ming Wu, I-Rue Lai, Shiow-Ching Shun
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Sophia Kristina Rupp, Andreas Stengel
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Nutritional status, sarcopenia, gastrointestinal symptoms and quality of life after gastrectomy for cancer – A cross-sectional pilot study
Sedegheh Gharagozlian, Tom Mala, Hilde Kristin Brekke, Lisa C. Kolbjørnsen, Åslaug A. Ullerud, Egil Johnson
Clinical Nutrition ESPEN.2020; 37: 195. CrossRef
Advantages of Distal Subtotal Gastrectomy over Total Gastrectomy in the Quality of Life of Long-Term Gastric Cancer Survivors
Oh Kyoung Kwon, Byunghyuk Yu, Ki Bum Park, Ji Yeon Park, Seung Soo Lee, Ho Young Chung
Journal of Gastric Cancer.2020; 20(2): 176. CrossRef
Chronological changes in quality of life and body composition after gastrectomy for locally advanced gastric cancer
Ki Bum Park, Ji Yeon Park, Seung Soo Lee, Ho Young Chung, Oh Kyoung Kwon
Annals of Surgical Treatment and Research.2020; 98(5): 262. CrossRef
Health-related quality of life in curatively-treated patients with esophageal or gastric cancer: A systematic review and meta-analysis
Héctor G. van den Boorn, Charlotte I. Stroes, Aeilko H. Zwinderman, Wietse J. Eshuis, Maarten C.C.M. Hulshof, Faridi S. van Etten-Jamaludin, Mirjam A.G. Sprangers, Hanneke W.M. van Laarhoven
Critical Reviews in Oncology/Hematology.2020; 154: 103069. CrossRef
Impact of body mass index on quality of life after distal gastrectomy for gastric cancer
Ki Bum Park, Byunghyuk Yu, Ji Yeon Park, Oh Kyoung Kwon, Wansik Yu
Annals of Surgical Treatment and Research.2019; 96(5): 250. CrossRef

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Body Mass Index and Doses at Organs at Risk in a Mediterranean Population Treated with Postoperative Vaginal Cuff Brachytherapy: Sebastia Sabater, Meritxell Arenas, Roberto Berenguer, Ignacio Andres, Esther Jimenez-Jimenez, Ana Martos, Jesus Fernandez-Lopez, Mar Sevillano, Angeles Rovirosa; Cancer Res Treat. 2015;47(3):473-479. Published online November 24, 2014; DOI: https://doi.org/10.4143/crt.2014.115

Abstract PDF PubReader ePub

Purpose
Association between body mass index (BMI) and doses in organs at risk during postoperative vaginal cuff brachytherapy (VCB) treatment has not been evaluated. The aim of this study was to analyse the impact of BMI on the dose delivered to bladder and rectum during high-dose-rate VCB using computed tomography (CT) scans at every fraction.
Materials and Methods
A retrospective analysis of 220 planning CT sets derived from 59 patients was conducted. Every planning CT was re-segmented and re-planned under the same parameters. Rectum and bladder dose-volume histogram values (D0.1cc, D1cc, and D2cc) were extracted and evaluated. The mean values for all applications per patient were calculated and correlated with BMI, as well as other factors influencing rectal and bladder doses. Multiple regression analysis performed to model organ at risk dose-volume parameters.
Results
According to World Health Organization (WHO), 6.8% of patients were normal, 35.6% were overweight, and 57.6% were class I obese. Median rectal doses were 133.5%, 110.9%, and 99.3% for D0.1cc, D1cc, and D2cc, respectively. The corresponding median bladder doses were 96.2%, 80.6%, and 73.3%, respectively. BMI did not show significant association with rectal doses. However, BMI did show a significant association with evaluated bladder dose metrics (D0.1cc, r=–0.366, p=0.004; D1cc, r=–0.454, p < 0.001; D2cc, r=–0.451, p < 0.001). BMI was retained in the multivariate regression models (D0.1cc, p=0.004; D1cc, p < 0.001; D2cc, p=0.001).
Conclusion
In this group of Mediterranean, overweight, and moderately obese patients, BMI showed association with lower bladder dose values, but not with rectal doses.

Citations

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Investigating the Influence of Body Mass Index on Organs at Risk Doses for Adjuvant High-Dose-Rate Vaginal Cuff Brachytherapy in Patients with Early-Stage Endometrial Carcinoma: A Single-Center Experience
Alexandra Timea Kirsch-Mangu, Diana Cristina Pop, Alexandru Țipcu, Andrei-Rareș Avasi, Claudia Ordeanu, Ovidiu Florin Coza, Alexandru Irimie
Diagnostics.2025; 15(7): 795. CrossRef
Vaginal dilator use more than 9 months is a main prognostic factor for reducing G2‑late vaginal complications in 3D‑vaginal‑cuff brachytherapy (interventional radiotherapy)?
Yaowen Zhang, Faegheh Noorian, Rosa Abellana, José Rochera, Antonio Herreros, Gabriela Antelo, Valentina Lancellotta, Luca Tagliaferri, Qian Han, Aureli Torne, Angeles Rovirosa
Clinical and Translational Oncology.2023; 25(6): 1748. CrossRef
Dose and secondary cancer-risk estimation of patients undergoing high dose rate intracavitary gynaecological brachytherapy
Chris Osam Doudoo, Prince Kwabena Gyekye, Geoffrey Emi-Reynolds, Simon Adu, David Okoh Kpeglo, Samuel Nii Adu Tagoe, Kofi Agyiri
Journal of Medical Imaging and Radiation Sciences.2023; 54(2): 335. CrossRef
Influence of body habitus on dose parameters of nodal levels III to IV irradiation for breast cancer: comparison of 3 techniques
Sebastia Sabater, Marina Gascon, Manuel Gutierrez-Perez, Roberto Berenguer, Ellen M. Donovan, Emma J. Harris, Meritxell Arenas
Medical Dosimetry.2018; 43(4): 328. CrossRef
Does postoperative irradiation improve survival in early-stage endometrial cancer?
Sebastia Sabater, Ignacio Andres, Veronica Lopez-Honrubia, Maria Magdalena Marti-Laosa, Susana Castro-Larefors, Roberto Berenguer, Esther Jimenez-Jimenez, Marimar Sevillano, Angeles Rovirosa, Meritxell Arenas
Brachytherapy.2018; 17(6): 912. CrossRef
Body mass index and outcomes of endometrial and ovarian cancer patients
Anke Smits, Alberto Lopes, Ruud Bekkers, Leon Massuger, Khadra Galaal
Expert Review of Quality of Life in Cancer Care.2016; 1(3): 221. CrossRef

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Effect of p53 and p16 Protein Expression in Relation to Body Mass Index for Breast Cancer Risk: Mi Kyung Kim, Jung Yeon Kim, Gyung yub Gong, Sei Hyun Ahn; J Korean Cancer Assoc. 2001;33(2):149-157.

Abstract PDF: PURPOSE
This study was conducted to investigate whether breast cancer with p53 protein overexpression (p53+) and loss of p16 protein expression (p16-) shows different body size indicator (height, weight, body mass index) associations as compared with breast tumors without p53 protein overexpression and the loss of p16 expression (p53-, p16+).
MATERIALS AND METHODS
A hospital based case-control study was conducted among 92 women patients and 122 control subjects. The p53 protein overexpression and loss of p16 protein expression in the tissue sections of patients with breast cancer were determined using immunohistochemistry.
RESULTS
A total of 26 tumors (28%) demonstrated p53 overexpression and 35 tumors (46%) showed abnormal p16 expression. The heaviest women had a higher risk with p53- and p16+ breast tumors. The odds ratios (OR) adjusted for age, menopausal status, smoking, and drinking revealed a significant gradient of increasing risk of breast cancer with increasing BMI in p53- and p16+ breast cancer. The adjusted ORs for the highest quintile of BMI was 8.51 with p53+ tumors and 14.2 with p53- tumors, and 55.6 with p16+ tumors and 3.72 with p16- tumors. p53 protein overexpression and the loss of p16 expression did not significantly correlate with nodal status, tumor size, estrogen or progesterone receptor status.
CONCLUSION
The study concluded that a strong association between p53-/p16+ tumors and BMI suggests the occurrence of p53-/p16+ tumors is related with obesity as compared to p53-/p16+ tumors.

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Obesity Related to Breast Cancer Risk by Hormonal Receptor Status: Keun Young Yoo, Sue Kyung Park, Daehee Kang; J Korean Cancer Assoc. 2000;32(5):962-971.

Abstract PDF: PURPOSE
A hospital-based case-control study was designed to assess whether obesity may differ in breast cancer risk according to the estrogen receptor (ER) or progesterone receptor (PR) status.
MATERIALS AND METHODS
Information on life-styles was obtained in a hospital-based cancer registry at the Aichi Cancer Center Hospital, Japan, 1988~1992. Newly diagnosed cases with breast cancer (n=1,154) and controls with no history of cancer (n=21,714) were selected. Body mass index with known and suspected risk factors for breast cancer was included simultaneously in the logistic regression model. Hypothesis tests for differences in odds ratios were done by Wald test based on the polytomous logistic regression models.
RESULTS
Both current weight and body mass index were significantly related to the risk of breast cancer; OR for body weight per 5 kg=1.11 (1.05~1.73), OR for body mass index per 10 kg/m2=1.54 (1.25~1.90). The risks of both body weight and body mass index, however, was not modified by ER, nor by PR.
CONCLUSION
This study strongly suggests that obesity may be associated with breast cancer risk. The possibility that obesity differs according to hormonal receptor status should be pursued in further studies.

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Relation between Body Size and Body Mass Index and Breast Cancer by Menopausal Status in Korea: Se Hyun Ahn, Mi Kyung Kim, Suk Il Kim; J Korean Cancer Assoc. 1999;31(1):72-81.

Abstract PDF: PURPOSE
Because the breast cancer is one of the major causes of mortality among women, it is important to identify modifiable risk factors for this disease. Some reported that overweight/obesity is a risk factor for breast cancer, but the results are not consistent. Human breast cancer has different characteristics according to the status of menopause (premenopause and postmenopause). For the premenopaused women, the majority of the relevant prospective studies support an inverse relationship between body mass index and the development of breast cancer. In contrast, for the postmenopaused women, a positive relationship between body mass index and development of breast cancer has been reported in only half of prospective studies on this topic. This study was undertaken to determine the role of body size and body mass index by status of menopause in development of breast cancer in Korea using retrospective case-control study.
MATERIALS AND METHODS
The breast cancer cases (n=683) and controls (n=501) were recruited from January 1993 to April 1998 at the Asan Medical Center. The authors collected information on demographic, reproductive and anthropometric characteristics by interviews. Quetelets index was calculated using height and weight. Multiple logistic regression was done to estimate adjusted odds ratios (ORs) by menopausal status, controlling age, age at first full-tenn pregnancy, age at menarche, number of parity, family history of breast cancer.
RESULTS
Overall, there was a moderate, but significant association between obesity and breast cancer. Among premenopausal women, in comparison with women whose weights were less than 50 kg, the ORs for the upper quintile group of weight was 1.71 (95% confidence interval (CI), 1.01~2.89). The heaviest premenopausal women had a higher risk (OR=1.16, 95% CI, 1.05~1.29, P=0.005). The adjusted OR for the highest quintile of BMI relative to the lowest was 2.02 (95% CI, 1.18~3.45). Higher body mass index was significantly associated with increased risk of premenopausal breast cancer (OR=1.08, 95% CI, 1.02~1.15, P=0.006). Among postmenopausal women, higher body mass index and weight were associated with increased risk of breast cancer. In comparison with women whose weights were less than 50 kg, the OR for the upper quintile group of weight was 2.08 (95% CI, 1.064.08). The adjusted OR for the highest quintile of BMI relative to the lowest was 2.02 (95% CI, 1.02~4.01).
CONCLUSION
Our findings suggest that overweight/obesity may play an important role in the incidence of premenopausal and postmenopausal breast cancer in Korea.

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High Risk Group for Female Breast Cancer in Korea: Keun Young Yoo, Sue Kyung Park, Joohun Sung, Daehee Kang, Young Cheol Kim, Han Sung Kang, Jun Suk Suh, Jee Soo Kim, Ik Jin Yun, Sehwan Han, Dong Young Noh, Kyk Jin Choe; J Korean Cancer Assoc. 1998;30(3):435-449.

Abstract PDF: PURPOSE
A hospital-based case-control study was conducted to find out risk factors for developing breast cancer in Korea.
MATERIALS AND METHODS
Histologically confirmed incident cases of breast cancer(n=280) were selected from inpatients at the Department of General Surgery, Seoul National University Hospital during 1994 to 1997. Women with free of self-reporting past history of any malignancies were regarded as controls who were selected from the inpatients at the Department of Obstetrics and Gynecology of the same hospital during 1992 to 1994(n=930). Information on life-styles including reproductive factors were obtained by direct interview using questionnaire. Age- and education-adjusted odds ratio and 95% confidence interval were estimated by unconditional linear logistic regression.
RESULTS
Based on the risk factors identified by both this study and other epidemiologic studies previously performed in Korea, high risk group for female breast cancer in Korea was established as follows. (1) women with age over 50, (2) women who have a family history of breast cancer, (3) women with age at menarche before 14-year old, (4) women with age at menopause after 50-year old, (5) women who were not experienced a full term pregnancy, (5) nulliparous women (6) women with age at her first fullterm pregnancy after 35-year old (7) women who were not experienced breast feeding, (8) women with body mass index more than 25 kg/m2 or with body weight more than 64 kg.
CONCLUSION
Life-time risk of breast cancer, as an indicator of absolute risk, according to the risk factors should be pursued in further prospective studies with community population.

3,480 View
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