Body Surface Area of Adult Cancer Patients: An Italian Multicenter Retrospective Study

OBJECTIVES: To estimate the dose of many cancer therapies, a patient’s body weight or body surface area (BSA) are often used. However, very limited data on weight and BSA distributions in cancer patient populations are available in the literature, none specific to Italy. The aim is to overcome the lack of reliable data determining the weight and BSA distributions of cancer patients in our district.

METHODS: Adult patients (aged ≥18) resident in Emilia-Romagna region with histologically or cytologically confirmed diagnosis among lung, breast, prostate, colorectal, stomach cancers and myeloma, who initiated systemic anti-cancer treatment in the district of Romagna between 2011 and 2021 were considered. The clinical dataset was obtained from electronic health records. BSA (m2), calculated using Dubois-and-Dubois method, and weight (Kg) were analyzed by gender, tumor site, age class and treatment setting.

RESULTS: Among 21,250 patients, median age was 67 years (IQ-range: 57-75) and the majority was female (55.66%). Primary tumors were: breast cancer (32.76%) and NSCLC (23.19%). Median BSA was 1.66 m2 and 1.86 m2 for females and men, respectively. The highest median BSA was observed among breast (1.68m2) and prostate cancer (1.90m2), while the lowest for gastric cancers in both gender group (1.58 and 1.81m2). A similar trend was observed for weight. Focusing on breast, we observed a decreasing trend (-2.11%) of the median weight and BSA to the advancement of the treatment (from neoadjuvant to third or later-line).

CONCLUSIONS: No standard BSA and weight values for patients being treated in Italy are available on which to base accurate drug dose and cost calculations. Therefore, it is important to use appropriate data that take into consideration gender, tumor site and treatment setting. In the absence of reliable estimates of weight and BSA distribution, we believe these results may be generalized and used in future costings and budgeting for new agents.