***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: BACKGROUND / AIM We report on survival data of 595 patients with stage I-III lung cancer with respect to TNM classification . MATERIAL S AND METHODS We constructed a basic model consisting of stage and grade , and assessed the improvement of survival prediction after adding comorbidity data , spirometric data , clinical and laboratory parameters . RESULTS Body mass index ( BMI ) and presence of a cardiac disease reached statistical significance for prediction of overall survival in a Cox regression model . In addition to BMI ( < 25 kg/m(2 ) ) and the presence of cardiovascular disease , the spirometric variable ( FEV1 ) predicted early death ( less than five months postoperatively ) . When the survival r and om forest method was employed to predict disease outcome , creatinine levels and VO2 max became additional variables of interest for predicting survival . CONCLUSION We propose that our lung cancer data base may help to identify variables ( aside from histomorphological variables ) that are suitable for identifying patients at risk of death after surgical treatment of lung cancer Physical activity has been associated with lower  lung cancer incidence and mortality  in several population s. We investigated these relationships in the Women 's Health Initiative Observational Study ( WHI-OS ) and Clinical Trial ( WHI-CT ) prospect i ve cohort of postmenopausal women . The WHI study enrolled 161,808 women aged 50 - 79 years between 1993 and 1998 at 40 U.S. clinical centers ; 129,401 were eligible for these analyses . Cox proportional hazards models were used to assess the association of baseline  physical activity levels [ metabolic equivalent (MET)-min/week : none < 100 ( reference ) , low 100 to < 500 , medium 500 to < 1,200 , high 1,200 + ] and sedentary behavior with total lung cancer incidence and mortality . Over 11.8 mean follow-up years , 2,148 incident lung cancer cases and 1,365 lung cancer deaths were identified . Compared with no activity , higher physical activity levels at study entry were associated with lower lung cancer incidence [ p = 0.009 ; hazard ratios ( 95 % confidence intervals ) for each physical activity category : low , HR : 0.86 ( 0.76 - 0.96 ) ; medium , HR : 0.82 ( 0.73 - 0.93 ) ; and high , HR : 0.90 ( 0.79 - 1.03 ) ] , and mortality [ p < 0.0001 ; low , HR : 0.80 ( 0.69 - 0.92 ) ; medium , HR : 0.68 ( 0.59 - 0.80 ) ; and high , HR : 0.78 ( 0.66 - 0.93 ) ] . Body mass index ( BMI ) modified the association with lung cancer incidence ( p = 0.01 ) , with a stronger association in women with BMI < 30 kg/m(2 ) . Significant associations with sedentary behavior were not observed . In analyses by lung cancer subtype , higher total physical activity levels were associated with lower lung cancer mortality for both overall NSCLC and adenocarcinoma . In conclusion , physical activity may be protective for  lung cancer incidence and mortality in postmenopausal women , particularly in non-obese women Lung cancer is the most common cause of cancer death with unchanged mortality for 50 years . Only localized nonsmall-cell lung cancer ( NSCLC ) is curable . In these patients it is essential to accurately predict survival to help identify those that will benefit from treatment and those at risk of relapse . Despite needing this clinical information , prospect i ve data are lacking . We therefore prospect ively identified prognostic factors in patients with potentially curable lung cancer . Over 2 years , 110 consecutive patients with confirmed localized NSCLC ( stages 1–3A ) were recruited from a single tertiary center . Prognostic factors investigated included age , gender , body mass index ( BMI ) , performance status , comorbidity , disease stage , quality of life , and respiratory physiology . Patients were followed up for 3 - 5 years and mortality recorded . The data were analyzed using survival analysis methods . Twenty-eight patients died within 1 year , 15 patients died within 2 years , and 11 patients died within 3 years postsurgery . Kaplan-Meier survival estimates show a survival rate of 51 % at 3 years . Factors significantly ( p < 0.05 ) associated with poor overall survival were age at assessment , diabetes , serum albumin , peak VO2 max , shuttle walk distance , and predicted postoperative transfer factor . In multiple-variable survival models , the strongest predictors of survival overall were diabetes and shuttle walk distance . The results show that potentially curable lung cancer patients should not be discriminated against with respect to weight and smoking history . Careful attention is required when managing patients with diabetes . Respiratory physiologic measurements were of limited value in predicting long-term survival after lung cancer surgery Background Whether waist circumference provides clinical ly meaningful information not delivered by body-mass index regarding prediction of cause-specific death is uncertain . Methods We prospect ively examined  waist circumference ( WC ) and body-mass index ( BMI ) in relation to cause-specific death in 225,712 U.S. women and men . Cox regression was used to estimate relative risks and 95 % confidence intervals ( CI ) . Statistical analyses were conducted using SAS version 9.1 . Results During follow-up from 1996 through 2005 , we documented 20,977 deaths . Increased WC consistently predicted risk of death due to any cause as well as major causes of death , including deaths from cancer , cardiovascular disease , and non-cancer/non-cardiovascular diseases , independent of BMI , age , sex , race/ethnicity , smoking status , and alcohol intake . When WC and BMI were mutually adjusted in a model , WC was related to 1.37 fold increased risk of death from any cancer and 1.82 fold increase risk of death from cardiovascular disease , comparing the highest versus lowest WC categories . Importantly , WC , but not BMI showed statistically significant positive associations with deaths from lung cancer and chronic respiratory disease . Participants in the highest versus lowest WC category had a relative risk of death from lung cancer of 1.77 ( 95 % CI , 1.41 to 2.23 ) and of death from chronic respiratory disease of 2.77 ( 95 % CI , 1.95 to 3.95 ) . In contrast , subjects in the highest versus lowest BMI category had a relative risk of death from lung cancer of 0.94 ( 95 % CI , 0.75 to 1.17 ) and of death from chronic respiratory disease of 1.18 ( 95 % CI , 0.89 to 1.56 ) . Conclusions Increased abdominal fat measured by WC was related to a higher risk of deaths from major specific causes , including deaths from lung cancer and chronic respiratory disease , independent of BMI BACKGROUND In China , there have been few large prospect i ve studies of the associations of body mass index ( BMI ) with overall and cause-specific mortality that have simultaneously controlled for biases that can be caused by pre-existing disease and smoking . METHODS Prospect i ve cohort study of 224 064 men , of whom 40 700 died during follow-up between 1990 - 91 and 2006 . Analyses restricted to 142 214 men aged 40 - 79 years at baseline with no disease history and , to further reduce bias from pre-existing disease , at least 5 years of subsequent follow-up , leaving 17 800 deaths [ including 4165 stroke , 1297 coronary heart disease ( CHD ) , 3121 chronic obstructive pulmonary disease ( COPD ) ] . Adjusted hazard ratios ( HRs ) and 95 % confidence intervals ( 95 % CIs ) per 5 kg/m(2 ) calculated within either a lower ( 15 to < 23.5 kg/m(2 ) ) or higher ( 23.5 to < 35 kg/m(2 ) ) range . RESULTS The association between BMI and all-cause mortality was U-shaped with the lowest mortality at ∼22.5 - 25 kg/m(2 ) . In the lower range , 5 kg/m(2 ) higher BMI was associated with 14 % lower mortality ( HR 0.86 , 95 % CI 0.82 - 0.91 ) ; in the upper range , it was associated with 27 % higher mortality ( HR 1.27 , 95 % CI 1.15 - 1.40 ) . The absolute excess mortality in the lower range was largely accounted for by excess mortality from specific smoking-related diseases : 54 % by that for COPD , 12 % other respiratory disease , 13 % lung cancer , 11 % stomach cancer . The excess mortality in the upper BMI range was largely accounted for by excess mortality from specific vascular diseases : 55 % by that for stroke , 16 % CHD . In this range , 5 kg/m(2 ) higher BMI was associated with ∼50 % higher mortality from stroke ( HR 1.61 , 95 % CI 1.36 - 1.92 ) and CHD ( HR 1.48 , 95 % CI 1.12 - 1.95 ) . CONCLUSIONS For China , previous evidence may have overestimated the excess mortality at low BMI but underestimated that at high BMI . The main way obesity kills in China appears to be stroke Introduction : Traditional tumor-based staging systems provide limited information on the best treatment option for individual patients with advanced inoperable non-small cell lung cancer ( NSCLC ) . The Glasgow prognostic score ( GPS ) reflects the host systemic inflammatory response and is a vali date d independent prognostic factor in these patients . The aim of this study was to examine the clinical application of the pretreatment GPS in a mature cohort of patients with inoperable NSCLC . Methods : The data of 261 patients with inoperable NSCLC were collected prospect ively and before treatment . Information on patient demographics , body mass index , performance status ( PS ) , the modified Glasgow prognostic score ( mGPS ) , the prognostic index , and treatment received were included . Results : The majority of patients were aged 65 years or older ( 68 % ) , were men ( 59 % ) , had a body mass index more than 20 ( 89 % ) , and an Eastern Cooperative Oncology Group performance status ( ECOG-PS ) 0 or 1 ( 54 % ) . Most patients had a pretreatment mGPS = 1 ( 62 % ) and pretreatment prognostic index = 1 ( 56 % ) . During the follow-up period , 248 ( 95 % ) patients died , 246 from their disease . The median survival was 8 months . On multivariate analysis , age ( p = 0.001 ) , ECOG-PS ( p < 0.05 ) , mGPS ( p < 0.0001 ) , and tumor stage ( p < 0.0001 ) were independently associated with cancer-specific survival . Using 5-year cancer-specific mortality as an end point , the area under the receiver operator curve was 0.735 ( 95 % confidence interval [ CI ] , 0.566–0.903 ; p = 0.024 ) for the mGPS , 0.669 ( 95 % CI , 0.489–0.848 ; p = 0.106 ) for ECOG-PS , and 0.622 ( 95 % CI , 0.437–0.807 ; p = 0.240 ) for tumor , node , metastasis stage . Patients with an increased mGPS were more likely to have a poorer ECOG-PS ( p < 0.05 ) , an increased white cell count ( p < 0.05 ) , and received palliative treatment ( p < 0.05 ) . Conclusion : The pretreatment mGPS is a useful and important predictor of cancer-specific survival in patients with inoperable NSCLC . Basing clinical assessment on the mGPS has implication s for the routine monitoring and treatment of the patients OBJECTIVE Previous studies have suggested that marital status is associated with survival from lung cancer ; however , its association is not conclusive . The association between marital status and survival in Japanese patients with non-small cell lung cancer ( NSCLC ) was prospect ively investigated . METHODS Between July 1999 and July 2004 , a total of 1230 NSCLC patients were enrolled . The baseline survey consisted of the collection of clinical information and various demographic data , including marital status . A Cox regression model was used to estimate the hazards ratio ( HR ) of all-cause mortality adjustments for age , BMI , education level , performance status , histology type , clinical stage , smoking status , choice of definitive treatment , and depression . RESULTS The multivariable adjusted HR of male widowed patients versus male married patients was 1.7 ( 95 % confidence interval=1.2 - 2.5 , p=0.005 ) . However , no significant increased risk of death in female widowed patients compared with female married patients was observed ( HR=0.7 , 95 % confidence interval=0.5 - 1.1 , p=0.15 ) . With regard to separated/divorced and single patients no significant increased risk of death in male and /or female compared with married patients was observed . CONCLUSIONS The present data suggest that male widowed patients with NSCLC have a higher mortality 
    Output:
    
In conclusion , lung cancer patients with a higher BMI have a longer survival than those with a lower BMI .