Lung cancer outcomes: Are BMI and race clinically relevant?

The conclusion of the international lung cancer consortium “Underweight and obese female ever-smokers were associated with worse outcomes in White-patients. These BMI associations were not observed in Asian-patients and never-smokers …” is most questionable [ [1] Jiang M. Fares A.F. Shepshelovich D. et al. The relationship between body-mass index and overall survival in non-small cell lung cancer by sex, smoking status, and race: a pooled analysis of 20,937 International Lung Cancer Consortium (ILCCO) patients. Lung Cancer. 2020; (Online)https://doi.org/10.1016/j.lungcan.2020.11.029 Abstract Full Text Full Text PDF Scopus (5) Google Scholar ]. The relationship between body-mass index and overall survival in non-small cell lung cancer by sex, smoking status, and race: A pooled analysis of 20,937 International lung Cancer consortium (ILCCO) patientsLung CancerVol. 152PreviewStudies of Body Mass Index (BMI) and cancer have reported varying results. Obesity is a known risk factor for carcinogenesis [1–3]. Obesity is also a negative prognostic factor for several malignancies: The National Comprehensive Cancer Network Guidelines recommend maintaining an ideal BMI of between 20−25 kg/m2 as part of treatment and surveillance in breast, colon and esophageal cancers [4–7]. However, lung cancer epidemiologic studies consistently demonstrated a lower risk of death among overweight/obese patients with non-small cell lung cancer (NSCLC), a phenomenon known as the “obesity paradox”, and a higher risk among the underweight, when compared with patients who have normal BMI. Full-Text PDF A reply to “Lung cancer outcomes: Are BMI and race clinically relevant?”Lung CancerVol. 154PreviewWe have read the recent letter from Braillon and appreciate his interest in our work. We would like to reply to a few specific comments that he raised. While we certainly agree that meta-analyses should be pre-registered, pooled analyses based on individual-level data are not considered systematic reviews and thus, PRISMA or Cochrane would not be appropriate sources to pre-register such an analysis. Further, while we are highly supportive of open science platforms, it is not routine to pre-register observational analyses. Full-Text PDF