ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2021
Visceral Obesity Promotes Lung Cancer Progression-Toward Resolution of the Obesity Paradox in Lung Cancer.
Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 55 papers, 1 of them a synthesis that pooled it.
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Who cites it
55 citing papers in PubMed, 1 synthesis or guideline pooled it, 67 citations in OpenAlex.
- Association between metabolically healthy obesity and metastasis in lung cancer patients - a systematic review and meta-analysis.Frontiers in endocrinology · 2023Pooled it
- Obesity Promotes Lung Carcinogenesis Through Airway Immune Dysfunction.Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer · 2026Article
- Bioelectrical impedance-derived body composition and systemic therapy outcomes in non-small cell lung cancer.Translational lung cancer research · 2026Article
- Phenolic Endocrine-Disrupting Chemical Exposure and Systemic Biomarker Variability in Patients with Lung Cancer.Medicina (Kaunas, Lithuania) · 2026Article
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- Obesity and respiratory diseases: mechanisms, phenotypes, and clinical implications.Diabetology & metabolic syndrome · 2026Review
- The Role of the Ketogenic Diet in Lung Cancer: Current Evidence and Future Perspectives.Cancers · 2026Review
- Association Between Obesity and Sex-Related Survival Difference in Lung Cancer.JCO clinical cancer informatics · 2026Article
- Impact of combined skeletal muscle index, subcutaneous fat index, and visceral fat index on prognosis in non-metastatic non-small cell lung cancer.BMC pulmonary medicine · 2026Observational
- When adipose meets inflammation: a novel adiposity-inflammation signature predicts prognosis and chemotherapy benefit in locally advanced gastric cancer.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026Article
- Genome-wide DNA methylation profiling reveals body mass Index-dependent epigenetic signatures associated with lung cancer susceptibility.BMC cancer · 2026Article
- Association between lipid accumulation product and asthma in US adults: evidence from the NHANES 2005-2020.BMC pulmonary medicine · 2026Article
- Does pre-checkpoint inhibitor sarcopenia, visceral, or subcutaneous fat predict survival in non-small cell lung cancer patients?Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2025Article
- Glucagon-like peptide-1 receptor agonism improves lung cancer outcomes and tumor growth control.JCI insight · 2025Article
- Adjuvant chemotherapy before osimertinib inTranslational lung cancer research · 2025Article
- Exploration of Fully-Automated Body Composition Analysis Using Routine CT-Staging of Lung Cancer Patients for Survival Prognosis.Journal of cachexia, sarcopenia and muscle · 2025Article
- Association of CVAI with BMD, FRAX scores, and osteoporosis risk in Chinese elderly patients with hypertension.Scientific reports · 2025Article
- Impact of metabolic and nutritional disorders on the synergy between radiotherapy and immunotherapy in non-small-cell lung cancer.BMC cancer · 2025Article
- Abdominal obesity and the risk of young-onset dementia in women: a nationwide cohort study.Alzheimer's research & therapy · 2025Article
- Obesity-specific improvement of lung cancer outcomes and immunotherapy efficacy with metformin.Journal of the National Cancer Institute · 2025Article
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Authors and funding
17 authors at 1 institution in 1 country.
Funding
Abstract
introductionAlthough obesity is associated with adverse cancer outcomes in general, most retrospective clinical studies suggest a beneficial effect of obesity in NSCLC.
methodsHypothesizing that this "obesity paradox" arises partly from the limitations of using body mass index (BMI) to measure obesity, we quantified adiposity using preoperative computed tomography images. This allowed the specific determination of central obesity as abdominal visceral fat area normalized to total fat area (visceral fat index [VFI]). In addition, owing to the previously reported salutary effect of metformin on high-BMI patients with lung cancer, metformin users were excluded. We then explored associations between visceral obesity and outcomes after surgical resection of stage I and II NSCLC. We also explored potential immunologic underpinnings of such association using complimentary analyses of tumor gene expression data from NSCLC tumors and the tumor transcriptome and immune microenvironment in an immunocompetent model of lung cancer with diet-induced obesity.
resultsWe found that in 513 patients with stage I and II NSCLC undergoing lobectomy, a high VFI is associated with decreased recurrence-free and overall survival. VFI was also inversely related to an inflammatory transcriptomic signature in NSCLC tumors, consistent with observations made in immunocompetent murine models wherein diet-induced obesity promoted cancer progression while exacerbating elements of immune suppression in the tumor niche.
conclusionsIn all, this study uses multiple lines of evidence to reveal the adverse effects of visceral obesity in patients with NSCLC, which align with those found in animal models. Thus, the obesity paradox may, at least in part, be secondary to the use of BMI as a measure of obesity and the confounding effects of metformin use.
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