Cancer Research and Treatment

Original Articles

Association between Obesity and Melanoma Risk in an Asian Population: A Nationwide Cohort Study: Hye Yeon Koo, Kyungdo Han, Jihye Park, Jinhyung Jung, Seonghye Kim, Hyeonjin Cho, In Young Cho, Dong Wook Shin; Received February 14, 2025 Accepted June 17, 2025 Published online June 18, 2025; DOI: https://doi.org/10.4143/crt.2025.169 [Accepted]

Abstract PDF: Purpose
Previous studies from mostly Western populations have suggested possible associations between obesity and melanoma risk. This study aimed to investigate associations between obesity status and melanoma using a nationwide cohort of Koreans.
Materials and Methods
4,441,403 adults who received a national health examination in 2012 were included from the Korean National Health Insurance Service database, and followed until December 31, 2022. Obesity status was defined based on the body mass index at the baseline health examination. Cox proportional hazards analyses were performed to evaluate associations between obesity status and incident melanoma, with adjustment for confounders. Stratified analyses were performed by sex and menopausal status (in women).
Results
Overall, melanoma risk increased according to obesity status (p for trend=0.024); adjusted hazard ratios (95% confidence intervals) for melanoma risk were 0.766 (0.438–1.340) in underweight; 1.292 (1.072–1.557) in overweight; 1.202 (1.002–1.442) in obesity; and 1.191 (0.798–1.778) in severe obesity compared to normal weight (reference). In stratified analyses, similar trends to those of the overall study population were observed among men and premenopausal women (p for trend=0.052 in men and 0.036 in premenopausal women). Among premenopausal women, the risk of melanoma increased linearly with obesity status. Meanwhile, among postmenopausal women, melanoma risk showed no significant difference or trend according to obesity status.
Conclusion
Overweight and obesity were associated with increased risk of melanoma in a population-based cohort of Koreans. Obese individuals, especially men and premenopausal women, may require more thorough prevention and screening strategies for melanoma.

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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

Weight Change after Cancer Diagnosis and Risk of Diabetes Mellitus: A Population-Based Nationwide Study: Hye Yeon Koo, Kyungdo Han, Mi Hee Cho, Wonyoung Jung, Jinhyung Jung, In Young Cho, Dong Wook Shin; Cancer Res Treat. 2025;57(2):339-349. Published online August 29, 2024; DOI: https://doi.org/10.4143/crt.2024.586

Abstract PDF Supplementary Material PubReader ePub

Purpose
Cancer survivors are at increased risk of diabetes mellitus (DM). Additionally, the prevalence of obesity, which is also a risk factor for DM, is increasing in cancer survivors. We investigated the associations between weight change after cancer diagnosis and DM risk.
Materials and Methods
This retrospective cohort study used data from the Korean National Health Insurance Service. Participants who were newly diagnosed with cancer from 2010 to 2016 and received national health screening before and after diagnosis were included and followed until 2019. Weight change status after cancer diagnosis was categorized into four groups: sustained normal weight, obese to normal weight, normal weight to obese, or sustained obese. Cox proportional hazard analyses were performed to examine associations between weight change and DM.
Results
The study population comprised 264,250 cancer survivors. DM risk was highest in sustained obese (adjusted hazard ratios [aHR], 2.17; 95% confidence interval [CI], 2.08 to 2.26), followed by normal weight to obese (aHR, 1.66; 95% CI, 1.54 to 1.79), obese to normal weight (aHR, 1.29; 95% CI, 1.21 to 1.39), and then sustained normal weight group (reference). In subgroup analyses according to cancer type, most cancers showed the highest risks in sustained obese group.
Conclusion
Obesity at any time point was related to increased DM risk, presenting the highest risk in cancer survivors with sustained obesity. Survivors who changed from obese to normal weight had lower risk than survivors with sustained obesity. Survivors who changed from normal weight to obese showed increased risk compared to those who sustained normal weight. Our finding supports the significance of weight management among cancer survivors.

Citations

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Effects of smoking behavior change on diabetes incidence after cancer development: A nationwide cohort study
MI Hee Cho, Jinhyung Jung, Hye Yeon Koo, Wonyoung Jung, Kyungdo Han, In Young Cho, Dong Wook Shin
Diabetes & Metabolism.2025; 51(1): 101604. CrossRef

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Gastrointestinal cancer

Association between the Persistence of Obesity and the Risk of Gastric Cancer: A Nationwide Population-Based Study: Joo Hyun Lim, Cheol Min Shin, Kyung-Do Han, Seung Woo Lee, Eun Hyo Jin, Yoon Jin Choi, Hyuk Yoon, Young Soo Park, Nayoung Kim, Dong Ho Lee; Cancer Res Treat. 2022;54(1):199-207. Published online May 4, 2021; DOI: https://doi.org/10.4143/crt.2021.130

Abstract PDF Supplementary Material PubReader ePub

Purpose
There remains controversy about relationship between obesity and gastric cancer. We aimed to examine the association using obesity-persistence.
Materials and Methods
We analyzed a nationwide population-based cohort which underwent health check-up between 2009 and 2012. Among them, those who had annual examinations during the last 5 years were selected. Gastric cancer risk was compared between those without obesity during the 5 years (never-obesity group) and those with obesity diagnosis during the 5 years (non-persistent obesity group; persistent obesity group).
Results
Among 2,757,017 individuals, 13,441 developed gastric cancer after median 6.78 years of follow-up. Gastric cancer risk was the highest in persistent obesity group (incidence rate [IR], 0.89/1,000 person-years; hazard ratio [HR], 1.197; 95% confidence interval [CI], 1.117 to 1.284), followed by non-persistent obesity group (IR, 0.83/1,000 person-years; HR, 1.113; 95% CI, 1.056 to 1.172) compared with never-obesity group. In subgroup analysis, this positive relationship was true among those < 65 years old and male. Among heavy-drinkers, the impact of obesity-persistence on the gastric cancer risk far increased (non-persistent obesity: HR, 1.297; 95% CI, 1.094 to 1.538; persistent obesity: HR, 1.351; 95% CI, 1.076 to 1.698).
Conclusion
Obesity-persistence is associated with increased risk of gastric cancer in a dose-response manner, especially among male < 65 years old. The risk raising effect was much stronger among heavy-drinkers.

Citations

Citations to this article as recorded by

Adiposity and risks of gastrointestinal cancers: A 10‐year prospective study of 0.5 million Chinese adults
Wing Ching Chan, Iona Millwood, Christiana Kartsonaki, Huaidong Du, Daniel Schmidt, Rebecca Stevens, Junshi Chen, Pei Pei, Canqing Yu, Dianjianyi Sun, Jun Lv, Xianyong Han, Liming Li, Zhengming Chen, Ling Yang
International Journal of Cancer.2025; 156(11): 2094. CrossRef
Association of overweight/obesity and digestive system cancers: A meta-analysis and trial sequential analysis of prospective cohort studies
Ji Ren, Chunyan Tang, Jinghe Wang, Yanan Wang, Dongying Yang, Jianming Sheng, Shili Zhu, Yunli Liu, Xiaoqi Li, Wei Liu, Mulu Tiruneh,
PLOS ONE.2025; 20(4): e0318256. CrossRef
Assessing gastric cancer risk through longitudinal health check-up data: Insights from a national cohort study in South Korea
Juwon Park, Do-young Kim, Mina Suh, Yeong-Hwa Kim, Sungho Won, Patricia Khashayar
PLOS ONE.2025; 20(4): e0312861. CrossRef
Diagnosis of gastric cancer in role of endoscopic imaging techniques in artificial intelligence and machine learning applications: An overview
Pooja K., Kishore Kanna R., G. Li, U. Subramaniam, M. Sekar
E3S Web of Conferences.2024; 491: 03016. CrossRef
Joint association of drinking alcohol and obesity in relation to cancer risk: A systematic review and data synthesis
Graeme A. Macdonald, James A. Thomas, Christine Dalais, Bradley J. Kendall, Aaron P. Thrift
Cancer Epidemiology.2024; 91: 102596. CrossRef
Roles of long non‑coding RNA SNHG16 in human digestive system cancer (Review)
Lujie Zhao, Yuling Kan, Lu Wang, Jiquan Pan, Yun Li, Haiyan Zhu, Zhongfa Yang, Lin Xiao, Xinhua Fu, Fujun Peng, Haipeng Ren
Oncology Reports.2024;[Epub] CrossRef
Gastric Cancer Risk in Association with Underweight, Overweight, and Obesity: A Systematic Review and Meta-Analysis
Narges Azizi, Moein Zangiabadian, Golnoosh Seifi, Afshan Davari, Elham Yekekhani, Seyed Amir Ahmad Safavi-Naini, Nathan A. Berger, Mohammad Javad Nasiri, Mohammad-Reza Sohrabi
Cancers.2023; 15(10): 2778. CrossRef
Recent research progress on the correlation between metabolic syndrome and Helicobacter pylori infection
Qinli Xie, Yangjun He, Danni Zhou, Yi Jiang, Ying Deng, Ruoqing Li
PeerJ.2023; 11: e15755. CrossRef
Risk of gastric cancer in relation with serum cholesterol profiles: A nationwide population-based cohort study
Mi Jin Oh, Kyungdo Han, Bongseong Kim, Joo Hyun Lim, Bokyung Kim, Sang Gyun Kim, Soo-Jeong Cho
Medicine.2023; 102(48): e36260. CrossRef
Decreasing Incidence of Gastric Cancer with Increasing Time after Helicobacter pylori Treatment: A Nationwide Population-Based Cohort Study
Taewan Kim, Seung In Seo, Kyung Joo Lee, Chan Hyuk Park, Tae Jun Kim, Jinseob Kim, Woon Geon Shin
Antibiotics.2022; 11(8): 1052. CrossRef
Integration of clinical and transcriptomics reveals programming of the lipid metabolism in gastric cancer
Yanyan Li, Jungang Zhao, Renpin Chen, Shengwei Chen, Yilun Xu, Weiyang Cai
BMC Cancer.2022;[Epub] CrossRef
Body fatness associations with cancer: evidence from recent epidemiological studies and future directions
Susanna C. Larsson, Nikolaos Spyrou, Christos S. Mantzoros
Metabolism.2022; 137: 155326. CrossRef
FOXC2-AS1 stabilizes FOXC2 mRNA via association with NSUN2 in gastric cancer cells
Jijun Yan, Juntao Liu, Zhengbin Huang, Wenwei Huang, Jianfa Lv
Human Cell.2021; 34(6): 1755. 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

Abstract PDF PubReader ePub

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

Citations to this article as recorded by

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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9 Web of Science
9 Crossref

Association of Body Composition with Long-Term Survival in Non-metastatic Rectal Cancer Patients: Jin Soo Han, Hyoseon Ryu, In Ja Park, Kyung Won Kim, Yongbin Shin, Sun Ok Kim, Seok-Byung Lim, Chan Wook Kim, Yong Sik Yoon, Jong Lyul Lee, Chang Sik Yu, Jin Cheon Kim; Cancer Res Treat. 2020;52(2):563-572. Published online December 3, 2019; DOI: https://doi.org/10.4143/crt.2019.249

Abstract PDF PubReader ePub

Purpose
We evaluated the association of body composition with long-term oncologic outcomes in non-metastatic rectal cancer patients.
Methods
We included 1,384 patients with stage(y)0-III rectal cancer treated at Asan Medical Center between January 2005 and December 2012. Body composition at diagnosis was measured using abdomino-pelvic computed tomography (CT). Sarcopenia, visceral obesity (VO), and sarcopenic obesity (SO) were defined using CT measured parameters such as skeletal muscle index (total abdominal muscle area, TAMA), visceral fat area (VFA), and VFA/TAMA. Inflammatory status was defined as a neutrophil-lymphocyte ratio of ≥3. Obesity was categorized by body mass index (≥ 25 kg/m²).
Results
Among the 1,384 patients, 944 (68.2%) had sarcopenia and 307 (22.2%) had SO. The 5-year overall survival (OS) rate was significantly lower in sarcopenic patients (no sarcopenia vs. sarcopenia; 84% vs. 78%, p=0.003) but the 5-year recurrence-free survival (RFS) rate was not different (77.3% vs. 77.9% p=0.957). Patients with SO showed lower 5-year OS (79.1% vs. 75.5% p=0.02) but no difference in 5-year RFS (p=0.957). Sarcopenia, SO, VO, and obesity were not associated with RFS. However, obesity, SO, age, sex, inflammatory status, and tumor stage were confirmed as independent factors associated with OS on multivariate analysis. In subgroup analysis, association of SO with OS was more prominent in patients with (y)p stage 0-2 and no inflammatory status.
Conclusion
The presence of SO and a low body mass index at diagnosis are negatively associated with OS in non-metastatic rectal cancer patients.

Citations

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Tuba Nur Yıldız Kopuz, Hanifi Furkan Yıldız, Sadettin Er, Mehmet Fisunoğlu
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T. S. Boldyreva, V. K. Lyadov
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Yulong Wang, Xijuan Liu, Xiao Feng, Xing Jiang, Lili Huang
Frontiers in Oncology.2025;[Epub] CrossRef
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Shameema Farook, Saumya Soni, Arpit Shantagiri, Pankaj Gupta, Anindita Sinha, Mahesh Prakash
Journal of Gastrointestinal and Abdominal Radiology.2024; 07(01): 027. CrossRef
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Huiyu Tang, Rongna Lian, Runjie Li, Jiaojiao Jiang, Ming Yang
Heliyon.2024; 10(2): e24696. CrossRef
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Qiutong Su, Jia Shen, Zubing Mei
PLOS ONE.2024; 19(5): e0303494. CrossRef
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Mihaela Jurdana, Maja Cemazar
Radiology and Oncology.2024; 58(1): 1. CrossRef
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Takeshi Nishikawa, Tetsuro Taira, Nao Kakizawa, Riki Ohno, Toshiya Nagasaki
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Nerea Becerra‐Tomás, Georgios Markozannes, Margarita Cariolou, Katia Balducci, Rita Vieira, Sonia Kiss, Dagfinn Aune, Darren C. Greenwood, Laure Dossus, Ellen Copson, Andrew G. Renehan, Martijn Bours, Wendy Demark‐Wahnefried, Melissa M. Hudson, Anne M. Ma
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Hye Jung Cho, Jeonghyun Kang
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Mingming Song, Zhihao Liu, Feihong Wu, Tong Nie, Yixin Heng, Jiaxin Xu, Ning Huang, Xiaoyu Wu, Yinghao Cao, Gang Hu
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Han Zhou, Lei Tian, Yiting Wu, Sibin Liu
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Wen‐Li Lin, Li‐Min Wu, Wen‐Tsung Huang, How‐Ran Guo, Jyh‐Jou Chen
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Jiyang Liu, Xiongfeng Yu, Xueqing Huang, Qingquan Lai, Jieyun Chen
Cancer Imaging.2023;[Epub] CrossRef
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Livingstone Aduse-Poku, Shama D. Karanth, Meghann Wheeler, Danting Yang, Caretia Washington, Young-Rock Hong, Todd M. Manini, Jesus C. Fabregas, Ting-Yuan David Cheng, Dejana Braithwaite
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Giuseppe Portale, Matteo Zuin, Ylenia Camilla Spolverato, Patrizia Bartolotta, Dario Gregori, Carlo Rettore, Luca Cancian, Alberto Morabito, Teodoro Sava, Valentino Fiscon
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Giuseppe Portale, Patrizia Bartolotta, Danila Azzolina, Dario Gregori, Valentino Fiscon
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Scientific Reports.2023;[Epub] CrossRef
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Antti Tolonen, Hanna Kerminen, Kaisa Lehtomäki, Heini Huhtala, Maarit Bärlund, Pia Österlund, Otso Arponen
Cancers.2023; 15(13): 3398. CrossRef
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Yoko Saino, Fumiya Kawase, Ayano Nagano, Junko Ueshima, Haruko Kobayashi, Kenta Murotani, Tatsuro Inoue, Shinsuke Nagami, Mizue Suzuki, Keisuke Maeda
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Jie He, Wei Luo, Yuanyuan Huang, Lingmeng Song, Yang Mei
Frontiers in Oncology.2023;[Epub] CrossRef
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Alessandro Giani, Simone Famularo, Alessandro Fogliati, Luca Riva, Nicolò Tamini, Davide Ippolito, Luca Nespoli, Marco Braga, Luca Gianotti
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Perry J. Pickhardt
Radiology.2022; 303(2): 241. CrossRef
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Gianluca Gortan Cappellari, Caterina Brasacchio, Daniela Laudisio, Carla Lubrano, Francesca Pivari, Luigi Barrea, Giovanna Muscogiuri, Silvia Savastano, Annamaria Colao
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David D. B. Bates, Perry J. Pickhardt
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Yueli Zhu, Xiaoming Guo, Qin Zhang, Yunmei Yang, Zubing Mei
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Quoc Riccardo Bao, Filippo Crimì, Giovanni Valotto, Valentina Chiminazzo, Francesca Bergamo, Alessandra Anna Prete, Sara Galuppo, Badr El Khouzai, Emilio Quaia, Salvatore Pucciarelli, Emanuele Damiano Luca Urso
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Young Il Kim, In Ja Park, Chan Wook Kim, Yong Sik Yoon, Seok-Byung Lim, Chang Sik Yu, Jin Cheon Kim, Yura Lee, Harin Kim, Seockhoon Chung, Chang-Min Choi, Hui Jeong Lee, Kyung Won Kim, Yousun Ko, Sung-Cheol Yun, Min-Woo Jo, Jong Won Lee
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Serial Changes in Body Composition and the Association with Disease Activity during Treatment in Patients with Crohn’s Disease
Ji Young Lee, Kyung Won Kim, Yousun Ko, Chi Hyuk Oh, Bo Hyun Kim, Seong Jin Park, Myung-Won You
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Antti Tolonen, Tomppa Pakarinen, Antti Sassi, Jere Kyttä, William Cancino, Irina Rinta-Kiikka, Said Pertuz, Otso Arponen
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Daniel Martin, Jens von der Grün, Claus Rödel, Emmanouil Fokas
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Body Mass Index and Risk of Gastric Cancer in Asian Adults: A Meta-Epidemiological Meta-Analysis of Population-Based Cohort Studies: Jong-Myon Bae; Cancer Res Treat. 2020;52(2):369-373. Published online August 12, 2019; DOI: https://doi.org/10.4143/crt.2019.241

Abstract PDF PubReader ePub

Purpose
A previous meta-analysis (MA) published in 2009 reported that excess body weight was associated with an increased risk of gastric cancer in non-Asians, but not in Asians. The aim was to conduct a meta-epidemiological MA (MEMA) to evaluate association between excess body weight and the risk of gastric cancer in Asian adults with using the proposed classification of weight by body mass index (BMI) in Asian adults.
Materials and Methods
The selection criteria were population-based prospective cohort studies that measured BMI of cohort participants and evaluated a risk of gastric cancer. Overweight group (OW) and obesity group (OB) were defined as 23.0-24.9 and ≥ 25.0, respectively. A group only showing results for BMI over 23.0 was defined as overweight and obesity group (OWB). Random effect model was applied if I² value was over 50%.
Results
After four new studies were added through citation discovery tools, seven cohort studies with 21 datasets were selected finally for MEMA. The I² value of OW, OB, and OWB were 76.1%, 83.5%, and 97.1%, respectively. Only OWB in men had a I² value below 50% (22.5%) and showed a statistical significance with inverse association (summary relative risk, 0.79; 95% confidence interval, 0.77 to 0.81).
Conclusion
This MEMA supported the hypothesis that OW might be a protective factor in gastric cancer risk in Asian adults. It will be necessary to conduct additional cohort studies with lengthening follow-up periods and re-analyzing the effect of overweight and obesity classified by the Asian criteria.

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Zehua Chen, Jiawu Fan, Xiaolong Chen, Kun Yang, Kui Wang
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Aaron P. Thrift, Theresa Nguyen Wenker, Hashem B. El-Serag
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Abao Xing, Henry H. Y. Tong, Songyan Liu, Xiaobing Zhai, Li Yu, Kefeng Li
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Federico Belladelli, Francesco Montorsi, Alberto Martini
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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
Asia-Pacific Journal of Clinical Oncology.2024; 20(2): 299. CrossRef
Obesity in the Asia-Pacific Region: Current Perspectives
David Tak Wai Lui, Junya Ako, Jamshed Dalal, Alan Fong, Masashi Fujino, Ari Horton, Rungroj Krittayaphong, Wael Almahmeed, Anne Thushara Matthias, Adam J Nelson, Stephen J Nicholls, Richard O’Brien, Kian Keong Poh, Khalida Soomro, Khung Keong Yeo, Kathryn
Journal of Asian Pacific Society of Cardiology.2024;[Epub] CrossRef
An analysis of the global burden of gallbladder and biliary tract cancer attributable to high BMI in 204 countries and territories: 1990–2021
Zhuowen Hu, Xue Wang, Xin Zhang, Wuping Sun, Jun Mao
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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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Xiaolong Wang, Lin Li, Mingjian Bai, Jiaxin Zhao, Xiaojie Sun, Yu Gao, Haitao Yu, Xia Chen, Chunjing Zhang
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Kai-Feng Wang, Yi-Dan Chen, Li-Qin Mo, Zhen Zhang, Ya-Juan Liu, Jiang-Xiang Chen, Xin-Bing Sui, Tian Xie, Shi-Xiu Wu
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Chang Seok Bang, Jung Hwan Oh
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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.

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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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Effects of the Expression of Leptin and Leptin Receptor (OBR) on the Prognosis of Early-stage Breast Cancers: Yongnam Kim, Si-Young Kim, Jae Jin Lee, Jeongho Seo, Youn-Wha Kim, Suck Hwan Koh, Hwi-Joong Yoon, Kyung Sam Cho; Cancer Res Treat. 2006;38(3):126-132. Published online June 30, 2006; DOI: https://doi.org/10.4143/crt.2006.38.3.126

Abstract PDF PubReader ePub

Purpose

Obesity-related leptin and leptin receptor (OBR) have a relation to the development of cancer and metastasis and also the low survival rate for breast cancer patients. Leptin has been associated with increased aromatase activity and it displays functional cross-talk with estrogen. This study was designed to determine the relationship between the expression of leptin and OBR in breast cancer tissue and the prognosis of early-stage breast cancer patients, and especially for the tamoxifen-treated patients.

Materials and Methods

Ninety-five patients with early-stage breast cancer and who had undergone surgical treatment at Kyung Hee University Hospital between January 1994 and June 2004 were analyzed. The surgical specimens underwent immunohistochemical analysis for leptin and OBR. The patients' survival and clinical characteristics were obtained from the medical records.

Results

Of the 95 patients, 79 (83%) and 32 (33.7%) showed the expression of leptin and OBR in breast cancer tissue, respectively. The expression of leptin and OBR in breast cancer tissue was not significantly related to the clinicopathological characteristics, including obesity, the expression of hormonal receptor, the HER-2/neu expression, menopause, stage and the nuclear grade. The expression of leptin and OBR was not significantly related to the overall disease-free survival (DFS). For the tamoxifen-treated postmenopausal obese patients, the DFS of the leptin-positive group was higher than that of the leptin-negative group (p=0.017).

Conclusion

The expression of leptin and OBR in breast cancer tissue may be not a prognostic factor for disease-free survival of breast cancer patients. In the future, further studies are needed to determine whether leptin expression could be a predictive factor for tamoxifen therapy in the postmenopausal obese subgroup among the early breast cancer patients.

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Exploring the multifaceted role of obesity in breast cancer progression
Sooraj Kakkat, Prabhat Suman, Elba A. Turbat- Herrera, Seema Singh, Debanjan Chakroborty, Chandrani Sarkar
Frontiers in Cell and Developmental Biology.2024;[Epub] CrossRef
Greater Body Fatness Is Associated With Higher Protein Expression of LEPR in Breast Tumor Tissues: A Cross-Sectional Analysis in the Women’s Circle of Health Study
Adana A.M. Llanos, John B. Aremu, Ting-Yuan David Cheng, Wenjin Chen, Marina A. Chekmareva, Elizabeth M. Cespedes Feliciano, Bo Qin, Yong Lin, Coral Omene, Thaer Khoury, Chi-Chen Hong, Song Yao, Christine B. Ambrosone, Elisa V. Bandera, Kitaw Demissie
Frontiers in Endocrinology.2022;[Epub] CrossRef
Association of Serum Leptin with Prognostic Factors in Breast Cancer
Amirreza Hajati, Farshad Talebian, Asrin Babahajian, Nasrin Daneshkhah, Bayazid Ghaderi
Sudan Journal of Medical Sciences.2022; 17(1): 4. CrossRef
Roles and mechanisms of adipokines in drug resistance of tumor cells
Yan Li, Chunyan Yu, Weimin Deng
European Journal of Pharmacology.2021; 899: 174019. CrossRef
Immunohistochemical analysis of adipokine and adipokine receptor expression in the breast tumor microenvironment: associations of lower leptin receptor expression with estrogen receptor-negative status and triple-negative subtype
Adana A. M. Llanos, Yong Lin, Wenjin Chen, Song Yao, Jorden Norin, Marina A. Chekmareva, Coral Omene, Lei Cong, Angela R. Omilian, Thaer Khoury, Chi-Chen Hong, Shridar Ganesan, David J. Foran, Michael Higgins, Christine B. Ambrosone, Elisa V. Bandera, Kit
Breast Cancer Research.2020;[Epub] CrossRef
Leptin signaling axis specifically associates with clinical prognosis and is multifunctional in regulating cancer progression
Tsung-Chieh Lin, Kuan-Wei Huang, Chia-Wei Liu, Yu-Chan Chang, Wei-Ming Lin, Tse-Yen Yang, Michael Hsiao
Oncotarget.2018; 9(24): 17210. CrossRef
Immunohistochemical staining of leptin is associated with grade, stage, lymph node involvement, recurrence, and hormone receptor phenotypes in breast cancer
Mohamad Nidal Khabaz, Amer Abdelrahman, Nadeem Butt, Lila Damnhory, Mohamed Elshal, Alia M. Aldahlawi, Swsan Ashoor, Basim Al-Maghrabi, Pauline Dobson, Barry Brown, Kaltoom Al-Sakkaf, Mohmmad Al-Qahtani, Jaudah Al-Maghrabi
BMC Women's Health.2017;[Epub] CrossRef
Leptin, adipocytes and breast cancer: Focus on inflammation and anti-tumor immunity
Laetitia Delort, Adrien Rossary, Marie-Chantal Farges, Marie-Paule Vasson, Florence Caldefie-Chézet
Life Sciences.2015; 140: 37. CrossRef
Leptine : implication dans la physiopathologie du cancer du sein
Florence Caldefie-Chézet, Virginie Dubois, Laetitia Delort, Adrien Rossary, Marie-Paule Vasson
Annales d'Endocrinologie.2013; 74(2): 90. CrossRef
Serum leptin level and waist-to-hip ratio (WHR) predict the overall survival of metastatic breast cancer (MBC) patients treated with aromatase inhibitors (AIs)
Mehmet Artac, Hakan Bozcuk, Aysel Kıyıcı, Orhan Onder Eren, Melih Cem Boruban, Mustafa Ozdogan
Breast Cancer.2013; 20(2): 174. CrossRef
Leptin attenuates the anti-estrogen effect of tamoxifen in breast cancer
Xiaofeng Chen, Xiaoming Zha, Wei Chen, Tingting Zhu, Jinrong Qiu, Oluf Dimitri Røe, Jun Li, Zhaoxia Wang, Yongmei Yin
Biomedicine & Pharmacotherapy.2013; 67(1): 22. CrossRef
The role of leptin receptor gene polymorphisms in determining the susceptibility and prognosis of NSCLC in Chinese patients
Yuliang Li, Jianli Geng, Yongzheng Wang, Qinghua Lu, Yimeng Du, Wujie Wang, Zheng Li
Journal of Cancer Research and Clinical Oncology.2012; 138(2): 311. CrossRef
Leptin and breast cancer: an overview
Mehmet Artac, Kadri Altundag
Medical Oncology.2012; 29(3): 1510. CrossRef

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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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