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Old 05-19-2014, 10:22 AM   #1
'lizbeth
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Post Association between visceral adiposity, BMI, and clinical outcomes in postmenopausal

Association between visceral adiposity, BMI, and clinical outcomes in postmenopausal women with operable breast cancer.



bstract No:
513
Attend this session at the
2014 ASCO Annual Meeting!


Session: Breast Cancer - HER2/ER
Type: Poster Highlights Session
Time 1: Sunday June 1, 8:00 AM to 11:00 AM
Location 1: E354b

Time 2: Sunday June 1, 11:30 AM to 12:45 PM
Location 2: E Arie Crown Theater
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Author(s): Shalini Dalal, David Hui, Sai-ching J. Yeung, Gary B. Chisholm, Ijeoma Stephanie Ihenacho, Richard Ogunti, Maxine De la Cruz, Marieberta Vidal, Deepak Bedi, Rony Dev, Eduardo Bruera, Jennifer Keating Litton; The University of Texas MD Anderson Cancer Center, Houston, TX
Abstract Disclosures

Abstract:

Background: High body mass index (BMI), an indicator of excess body fat, has been shown to negatively impact clinical outcomes in breast cancer. Metabolic dysfunction associated with high visceral fat may be contributory. Since BMI provides no information on the anatomical distribution of stored fat, we conducted this retrospective study to examine the association between visceral adiposity parameters and clinical outcomes. Methods: 1,237 postmenopausal women with stage I-III invasive breast cancer, diagnosed between 1997 to 2012, and who received neoadjuvant chemotherapy (NC) were included. Computed tomography images were used to quantify visceral fat (VFA) and subcutaneous fat area (SFA). The VFA/SFA Ratio was used as a metric of regional fat distribution. We conducted univariate and multivariate analyses to examine the association between body composition parameters (VFA, SFA, VFA/SFA Ratio, BMI) and key outcomes (pathologic complete response [pCR], relapse-free [RFS], disease-specific [DSS] and overall survival [OS]), adjusting for demographics and known prognostic factors, including stage, tumor grade, receptor status and type of NC. Results: Median age was 58 years; 63% white. A majority were overweight (32%) or obese (44%). Median VFA was 110 cm2, SFA 239 cm2and VFA/SFA Ratio 0.41. In multivariate analysis, higher VFA (odds ratio [OR]=0.52; 95% CI, 0.36-0.75; p< 0.001) and lower SFA (OR=0.56; 95% CI, 0.39-0.81; p=0.002) were independently associated with lower likelihood of achieving pCR. Higher VFA/SFA Ratio was an independent predictor of lower RFS (hazard ratio [HR]=1.41; 95% CI 1.05-1.89; p=0.02), DSS (HR=1.71; 95% CI, 1.20-2.44; p=.003) and OS (HR=2.18; 95% CI, 1.52-3.13; p<0.001). Conclusions: Our study suggests fat-depot specific differences in breast cancer outcomes. Higher visceral fat and lower subcutaneous fat were independently associated with lower likelihood of pCR. Higher visceral to subcutaneous fat ratio predicted worse RFS, DSS and OS. The predisposition to accumulate fat viscerally versus subcutaneously may be a novel prognostic factor independent of BMI, absolute fat stores and tumor characteristics.
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