BACKGROUND: Although obesity is an established risk factor for developing colon cancer, its prognostic impact and relation to patient sex in colon cancer survivors remains unclear. METHODS: The authors examined the prognostic and predictive impact of the body mass index (BMI) in patients with stage II and III colon carcinoma (N = 25,291) within the Adjuvant Colon Cancer Endpoints (ACCENT) database. BMI was measured at enrollment in randomized trials of 5-fluorouracil-based adjuvant chemotherapy. Association of BMI with the time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS) were determined using Cox regression models. Statistical tests were 2-sided. RESULTS: During a median follow-up of 7.8 years, obese and underweight patients had significantly poorer survival compared with overweight and normal-weight patients. In a multivariable analysis, the adverse prognostic impact of BMI was observed among men but not among women (Pinteraction = .0129). Men with class 2 and 3 obesity (BMI ≥ 35.0 kg/m(2) ) had a statistically significant reduction in DFS (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.01-1.33; P = .0297) compared with normal-weight patients. Underweight patients had a significantly shorter TTR and reduced DFS (HR, 1.18; 95% CI, 1.09-1.28; P < .0001) that was more significant among men (HR, 1.31; 95% CI, 1.15-1.50; P < .0001) than among women (HR, 1.11; 95% CI, 1.01-1.23; P = .0362; Pinteraction = .0340). BMI was not predictive of a benefit from adjuvant treatment. CONCLUSIONS:Obesity and underweight status were associated independently with inferior outcomes in patients with colon cancer who received treatment in adjuvant chemotherapy trials.
RCT Entities:
BACKGROUND: Although obesity is an established risk factor for developing colon cancer, its prognostic impact and relation to patient sex in colon cancer survivors remains unclear. METHODS: The authors examined the prognostic and predictive impact of the body mass index (BMI) in patients with stage II and III colon carcinoma (N = 25,291) within the Adjuvant Colon Cancer Endpoints (ACCENT) database. BMI was measured at enrollment in randomized trials of 5-fluorouracil-based adjuvant chemotherapy. Association of BMI with the time to recurrence (TTR), disease-free survival (DFS), and overall survival (OS) were determined using Cox regression models. Statistical tests were 2-sided. RESULTS: During a median follow-up of 7.8 years, obese and underweight patients had significantly poorer survival compared with overweight and normal-weight patients. In a multivariable analysis, the adverse prognostic impact of BMI was observed among men but not among women (Pinteraction = .0129). Men with class 2 and 3 obesity (BMI ≥ 35.0 kg/m(2) ) had a statistically significant reduction in DFS (hazard ratio [HR], 1.16; 95% confidence interval [CI], 1.01-1.33; P = .0297) compared with normal-weight patients. Underweight patients had a significantly shorter TTR and reduced DFS (HR, 1.18; 95% CI, 1.09-1.28; P < .0001) that was more significant among men (HR, 1.31; 95% CI, 1.15-1.50; P < .0001) than among women (HR, 1.11; 95% CI, 1.01-1.23; P = .0362; Pinteraction = .0340). BMI was not predictive of a benefit from adjuvant treatment. CONCLUSIONS:Obesity and underweight status were associated independently with inferior outcomes in patients with colon cancer who received treatment in adjuvant chemotherapy trials.
Authors: V Paul Doria-Rose; Polly A Newcomb; Libby M Morimoto; John M Hampton; Amy Trentham-Dietz Journal: Cancer Causes Control Date: 2006-02 Impact factor: 2.506
Authors: Allison A Hedley; Cynthia L Ogden; Clifford L Johnson; Margaret D Carroll; Lester R Curtin; Katherine M Flegal Journal: JAMA Date: 2004-06-16 Impact factor: 56.272
Authors: Michael J O'Connell; Megan E Campbell; Richard M Goldberg; Axel Grothey; Jean-François Seitz; Jacqueline K Benedetti; Thierry André; Daniel G Haller; Daniel J Sargent Journal: J Clin Oncol Date: 2008-05-10 Impact factor: 44.544
Authors: Brian M Wolpin; Jeffrey A Meyerhardt; Andrew T Chan; Kimmie Ng; Jennifer A Chan; Kana Wu; Michael N Pollak; Edward L Giovannucci; Charles S Fuchs Journal: J Clin Oncol Date: 2008-12-08 Impact factor: 44.544
Authors: Kan Ho Chun; Byung Noe Bae; Hoon An; Hyeonseok Jeong; Hyunjin Cho; Geumhee Gwak; Keun Ho Yang; Ki Hwan Kim; Hong Ju Kim; Young Duk Kim Journal: Ann Coloproctol Date: 2014-12-31
Authors: M Agostina Santoro; R Eric Blue; Sarah F Andres; Amanda T Mah; Laurianne Van Landeghem; P Kay Lund Journal: Am J Physiol Gastrointest Liver Physiol Date: 2015-08-06 Impact factor: 4.052