Survival by Cumulative Time in Weight Category
Analysis of EFS from the start of maintenance was conducted for the subcohort of 1,581 patients alive and disease free at that time. Of these, 644 patients (40.7%) spent some time premaintenance at an extreme weight (obese, n 393; underweight, n 251), whereas 937 patients (59.3%) were normal/overweight for the entire time. In this group, children who spent 50% of the time either obese or underweight demonstrated inferior EFS as compared with those who had reduced exposure to either weight extreme (univariable P .008; Fig A Five-year EFS rates ( SD) for children who were either obese or underweight 50% of the time were 73% 3% and 70% 5%, respectively, compared with children who spent 50% of their time obese or underweight (77% 3% and 82% 3%, respectively) or were normal/overweight throughout (80% 1%). However, multivariable analysis (Table 2) revealed the greatest risk for an event was in patients who present adobes or under weight and then remained in their respective