{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T18:09:13Z","timestamp":1790791753726,"version":"4.1.0"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T00:00:00Z","timestamp":1666224000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J cachexia sarcopenia muscle"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Weight loss (WL) has been associated with shorter survival in patients with advanced cancer, while obesity has been associated with longer survival. Integrating body mass index (BMI) and WL provides a powerful prognostic tool but has not been well\u2010studied in lung cancer patients, particularly in the setting of clinical trials.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We analysed patient data (<jats:italic>n<\/jats:italic>\u00a0=\u00a010\u00a0128) from 63 National Cancer Institute sponsored advanced non\u2010small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) trials. Risk matrices were created using BMI and WL percentage, which were divided into \u2018grades\u2019 based on median survival. Relationships between survival, BMI and WL percentage were examined using Kaplan\u2013Meier estimators and Cox proportional hazards (PH) models with restricted cubic splines.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>For NSCLC, a twofold difference was noted in median survival between the BMI\u00a0&gt;\u00a028 and WL\u00a0\u2264\u00a05% group (13.5\u00a0months) compared with the BMI\u00a0&lt;\u00a020 and WL\u00a0&gt;\u00a05% group (6.6\u00a0months). These associations were less pronounced in SCLC. Kaplan\u2013Meier curves showed significant survival differences between grades for both NSCLC and SCLC (log\u2010rank, <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.0001). In Stage IV NSCLC, Cox PH analyses with restricted cubic splines demonstrated significant associations between BMI and survival in both WL\u00a0\u2264\u00a05% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0004) and &gt;5% (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0129) groups, as well as in WL\u00a0&gt;\u00a05% in Stage III (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.0306). In SCLC, these relationships were more complex.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>BMI and WL have strong associations with overall survival in patients with advanced lung cancer, with a greater impact seen in NSCLC compared with SCLC. The integration of a BMI\/WL grading scale may provide additional prognostic information and should be included in the evaluation of therapeutic interventions in future clinical trials in advanced lung cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jcsm.13095","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T02:40:45Z","timestamp":1666320045000},"page":"2650-2660","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":32,"title":["Associations between body mass index, weight loss and overall survival in patients with advanced lung cancer"],"prefix":"10.1002","volume":"13","author":[{"given":"Cameron","family":"Oswalt","sequence":"first","affiliation":[{"name":"Hematology &amp; Oncology Fellow, Department of Medicine Duke University Health System  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yingzhou","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Medical Informatics University of Wisconsin\u2013Madison  Madison WI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Herbert","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke Cancer Institute  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Le\u2010Rademacher","sequence":"additional","affiliation":[{"name":"Division of Clinical Trials and Biostatistics, Department of Quantitative Health Sciences Mayo Clinic  Rochester MN USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaofei","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics Duke Cancer Institute  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1274-1354","authenticated-orcid":false,"given":"Jeffrey","family":"Crawford","sequence":"additional","affiliation":[{"name":"Division of Medical Oncology, Department of Medicine Duke Cancer Institute  Durham NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,20]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMsa1909301"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)30175-1"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.3810\/pgm.2009.11.2074"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa055643"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199712000-00010"},{"key":"e_1_2_8_7_1","first-page":"625","article-title":"Involuntary weight loss","volume":"98","author":"Wong 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