91勛圖

Abstract

Obesity and diabetes reached epidemic proportion and may be associated with breast cancer (BC) survival outcomes. We therefore studied the association of obesity, diabetes and their combination (DM&Ob) with disease-free survival and overall survival. Our study included 991 pre and post-women with non-metastatic BC treated with mastectomy or breast-conserving surgery in two oncologic hospitals in Naples (Italy). Obesity was assessed as body mass index >30kg/m2, while diabetes was categorized according to the American diabetes association guidelines. Patients and tumor characteristics including staging and molecular subtyping were evaluated using the Kruskal-Wallis H test for age, the Mantel-Haenszel linear-by-linear association chi-square test for trends for the ordered categorical variables and chisquare test for other categorical variables. Patient outcomes were analyzed in terms of both disease-free survival (DFS; with local, contralateral and distant disease recurrence and secondary primary tumors and death from any cause defined as event) and overall survival (OS; with death from any cause defined as event). There were a total of 137 recurrences after five years, mostly in the DM and Ob group (28%). There were no significant differences in DFS or OS between obese only (p=0.4 and 0.7, respectively) or diabetes only (p=0.8 and 0.5, respectively) compared to those without obesity or without diabetes. The fully adjusted multivariate Cox regression analyses showed a direct association of DM and Ob with DFS (HR=2.54, 95% CI 1.30-4.98) and with OS (HR=2.30; 95% CI 1.02-5.17), suggesting that the co-presence of diabetes and obesity had an independent and strong prognostic value.

Biography

Maurizio Montella is a Medical Doctor having Specialization in Epidemiology and Public Health. He is the Head of Department of Epidemiology of the National Cancer Institute of Naples. He works with the Ministry of Health on low glycemic index diet, exercise and vitamin D to reduce breast cancer recurrence (DEDiCa): design of a clinical trial. He has 282 published papers with citation 6896 and H-Index 46.