Combined effect of obesity and diabetes on early breast cancer outcome: a prospective observational study
Bibliographic record
Abstract
// Giuseppe Buono 1, * , Anna Crispo 2, * , Mario Giuliano 1, 3 , Carmine De Angelis 1 , Francesco Schettini 1 , Valeria Forestieri 1 , Rossella Lauria 1 , Matilde Pensabene 1 , Michelino De Laurentiis 4 , Livia Silvia Adriana Augustin 2, 5 , Alfonso Amore 4 , Massimiliano D’Aiuto 4 , Raffaele Tortoriello 4 , Antonello Accurso 6 , Ernesta Cavalcanti 2 , Gerardo Botti 2 , Maurizio Montella 2 , Sabino De Placido 1 and Grazia Arpino 1 1 Department of Clinical Medicine and Surgery, Oncology Division, University of Naples Federico II, Naples, Italy 2 Unit of Epidemiology, National Cancer Institute, G. Pascale Foundation, Naples, Italy 3 Lester and Sue Smith Breast Center, Baylor College of Medicine, Houston, TX, USA 4 Breast Unit, National Cancer Institute, G. Pascale Foundation, Naples, Italy 5 Clinical Nutrition and Risk Factor Modification Centre, St. Michael’s Hospital, Toronto, Canada 6 Department of Gastroenterology, Endocrinology and Surgery, University of Naples Federico II, Naples, Italy * These authors contributed equally to this work Correspondence to: Grazia Arpino, email: grazia.arpino@unina.it Keywords: breast cancer; obesity; diabetes; combined variables; outcome Received: August 19, 2017 Accepted: November 16, 2017 Published: December 05, 2017 ABSTRACT Background: Previous studies suggested that obesity and diabetes were correlated with breast cancer outcome. The aim of the present study was to investigate the prognostic effect of obesity and diabetes on the outcome of early breast cancer patients. Materials and Methods: Overall, 841 early breast cancer patients were prospectively enrolled between January 2009 and December 2013. Study population was divided into four groups: (1) patients without obesity or diabetes; (2) patients with only diabetes; (3) patients with only obesity; and (4) patients with both diabetes and obesity. Categorical variables were analyzed by the chi-square test and survival data by the log-rank test. Results: At diagnosis, obese and diabetic patients were more likely to be older ( p < 0.0001) and post-menopausal ( p < 0.0001) and to have a tumor larger than 2 cm ( p < 0.0001) than patients in groups 1–3. At univariate analyses, obese and diabetic patients had a worse disease-free survival ( p = 0.01) and overall survival ( p = 0.001) than did patients without obesity and diabetes. At multivariate analyses, the co-presence of obesity and diabetes was an independent prognostic factor for disease-free survival (hazard ratio=2.62, 95% CI 1.23–5.60) but not for overall survival. Conclusions: At diagnosis, patients with obesity and diabetes were older, had larger tumors and a worse outcome compared to patients without obesity or diabetes. These data suggest that metabolic health influences the prognosis of patients affected by early breast cancer.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".