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開催概要
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第53回・2015年・京都
 

The impact of body fat distribution on neo-adjuvant chemotherapy for advanced breast cancer patients

演題番号 : P52-9

[筆頭演者]
Iwase Toshiaki:1 
[共同演者]
Sangai Takafumi:1、Nakagawa Ayako:1、Masuda Takahito:1、Ishigami Emi:1、Hayama Shouko:1、Sakakibara Junta:1、Sakakibara Masahiro:1、Nagashima Takeshi:1、Miyazaki Masaru:1

1:Department of General Surgery, Graduate School, Chiba University

 

Background: Studies have reported that obesity decreases the chemotherapeutic efficacy of neo-adjuvant chemotherapy (NAC) on breast cancer. However, the relationship between actual body fat distribution (BFD) and therapy outcome is still unknown. Therefore, we set out to clarify the effect of BFD on NAC.
Methods: A total of 172 cases with advanced breast cancer who underwent surgery after NAC between January 2004 and December 2012 were retrospectively analyzed. Subcutaneous fat area (SFA), visceral fat area (VFA), and skeletal muscle area (SMA) were calculated using computed tomography volume analyzing software, SYNAPSE VINCENT® (FUJIFILM Co., Ltd. Tokyo, Japan). VFA/SFA ratio was used for evaluating visceral obesity and Liver/Spleen attenuation ratio (L/S ratio) was also calculated for fatty liver evaluation. The relationships between those BFD parameters, pathological complete remission (pCR) and survival outcome were analyzed.
Results: In body composition analysis, SFA, and VFA were significantly correlated to body mass index (BMI)(p < 0.05, SFA; r = 0.71, VFA; r = 0.78). SFA and VFA were significantly increased after menopause, while SMA was significantly decreased (p < 0.05). In addition, VFA/SFA ratio was significantly increased after menopause, despite no significant change in BMI and L/S ratio. A total of 46 cases achieved pCR. However, BFD parameters were not associated with pCR. Survival analysis demonstrated high VFA group (>100 cm2) was significantly had worse DDFS compared to the low VFA group (p < 0.05). Moreover, that difference was more significant in postmenopausal group. Multivariate analysis demonstrated VFA, pCR, and subtypes were independent prognostic factors for DDFS.
Conclusion: Present study suggests that increased visceral fat after menopause significantly relates to the worse outcome after NAC. It is highly probable to give an appropriate intervention to those high-risk cases improve the outcome.

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臓器別:乳腺

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