Obesity or Overweight Is Associated with Worse Pathological Response to Neoadjuvant Chemotherapy among Chinese Women with Breast Cancer 英文参考文献.docVIP

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Obesity or Overweight Is Associated with Worse Pathological Response to Neoadjuvant Chemotherapy among Chinese Women with Breast Cancer 英文参考文献.doc

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Obesity or Overweight Is Associated with Worse Pathological Response to Neoadjuvant Chemotherapy among Chinese Women with Breast Cancer 英文参考文献

ObesityorOverweightIsAssociatedwithWorse PathologicalResponsetoNeoadjuvantChemotherapy amongChineseWomenwithBreastCancer ShengChen1,2,Can-MingChen1,2,YingZhou1,2,Ruo-JiZhou2,3,Ke-DaYu1,2,Zhi-MingShao1,2,4 * 1DepartmentofBreastSurgery,FudanUniversityShanghaiCancerCenter/CancerInstitute,Shanghai,P.R.China,2DepartmentofOncology,ShanghaiMedicalCollege, Fudan University, Shanghai, P.R. China, 3Department of Pathology, Fudan University Shanghai Cancer Center/Cancer Institute, Shanghai, P.R. China, 4Institutes of BiomedicalScience,FudanUniversity,Shanghai,P.R.China Abstract Background: To evaluate the relationship between body mass index (BMI) and response to neoadjuvant chemotherapy (NCT)forbreastcanceramongChinesewomen. PatientsandMethods:Atotalof307eligiblepatientswereassignedtoreceivefourcyclesofpaclitaxelandcarboplatin beforestandardsurgeryforbreastcancerfrom2007to2011atShanghaiCancerHospital.Thepatientswerecategorizedas obese,overweight,normalweight,orunderweightbasedonBMIaccordingtoWorldHealthOrganization(WHO)criteria. Pathologicalcompleteresponse(pCR)wasdefinedasnoinvasivecancerinthebreastoraxillarytissue.Alogisticregression and the Chi-squared test were used for detecting the predictors of pCR and determining the relationship between BMI categoryandpCRrateinthesubgroupanalysiswithrespecttoothervariables. Results:CategoricalBMI,estrogenreceptor(ER),andprogesteronereceptor(PR)statuswereindependentpredictorsofpCR according to the multivariate analysis. Patients with BMI$25 were less likely to achieve a pCR to NCT compared with patientswithBMI,25(Oddsratio:0.454,p=0.033,multivariateanalysis).Inthesubgroupanalysis,thepredictivevalueof BMIforpCRtoNCTwassignificantlyshowninpost-menopausalpatients(p=0.004)andhormonalreceptorstatus-negative patients(p=0.038).Theincidenceoftreatment-inducedtoxicitywassimilaramongthedifferentBMIcategories. Conclusion:HigherBMIwasassociatedwithworsepCRtoNCT.Furtherapproachestoinvestigatingthemechanismofthis influenceofBMIontreatmentresponse