To the Editor Caan et al1 conducted an interesting study to evaluate the associations of 3 body composition measures with overall survival (OS) in patients with nonmetastatic breast cancer. Comparing patients with and without sarcopenia, the authors report a hazard ratio (HR) of 1.41 (95% CI, 1.18-1.69). Although a statistically significant association between sarcopenia and OS was established, a 40% increase in the HR for sarcopenia is difficult to interpret clinically. The hazard cannot be interpreted as a risk (ie, the chance or likelihood of an event occurring). Moreover, without the background hazard function as a benchmark in patients without sarcopenia, a 40% increase might not amount to a clinically meaningful difference.2 Furthermore, when the HR is not constant over time, it is unclear how to interpret the observed HR.3
McCaw ZR, Liu D, Wei L. Body Composition and Overall Survival in Patients With Nonmetastatic Breast Cancer. JAMA Oncol. 2019;5(1):114–115. doi:10.1001/jamaoncol.2018.5290
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