Weight modification after a diagnosis of colon cancer and its impact on outcomes remain unclear. Thus we aimed to examine the association of obesity and weight changes from baseline oncology consultation with recurrence-free survival (RFS) and overall survival (OS) in patients with stage III colon cancer.
Patients aged ≥ 18 years who were diagnosed with stage III colon cancer in British Columbia from 2008 to 2010 and who received adjuvant chemotherapy were included in the study. Cox proportional hazards regression models were fitted to evaluate the impact of different body compositions and degree of weight changes from baseline assessment with outcomes while controlling for potentially confounding covariates, such as age and sex.
A total of 539 patients with stage III colon cancer were included: median age was 69 years (range, 26-94 years), 52% were men, and 53% had Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. Those with weight gains of ≥ 10% had a median RFS of 37 months compared with 49 months in those with weight gains of < 10% (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.56-1.59; P = .82). However, this finding was not significant. In Cox models, patients who exhibited weight losses of ≥ 10% experienced significantly inferior RFS (HR, 3.45; 95% CI, 1.44-8.13; P = .0046) and OS (HR, 2.63; 95% CI, 1.04-6.67; P = .041) compared with those who experienced weight losses of < 10%. Weight gains, losses, or changes of equal or less magnitude did not show any significant associations with outcomes (all P > .05).
Weight losses of ≥ 10% from baseline evaluation bodes a worse prognosis among patients with stage III colon cancer.
To read this article in full you will need to make a payment
Purchase one-time access:Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
One-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:Subscribe to Clinical Colorectal Cancer
Already a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
- Global cancer statistics.CA Cancer J Clin. 2011; 61: 69-90
- Comparison of risk factors for colon and rectal cancer.Int J Cancer. 2004; 108: 433-442
- Diet, body weight, and colorectal cancer: a summary of the epidemiologic evidence.J Womens Health (Larchmt). 2003; 12: 173-182
- Body mass index and colon cancer mortality in a large prospective study.Am J Epidemiol. 2000; 152: 847-854
- A quantitative analysis of body mass index and colorectal cancer: findings from 56 observational studies.Obes Rev. 2010; 11: 19-30
- Obesity and cancer risk: evidence, mechanisms, and recommendations.Ann N Y Acad Sci. 2012; 1271: 37-43
- Body mass index and outcomes in patients who receive adjuvant chemotherapy for colon cancer.J Natl Cancer Inst. 2006; 98: 1647-1654
- Impact of body mass index on survival after colorectal cancer diagnosis: the Cancer Prevention Study-II Nutrition Cohort.J Clin Oncol. 2012; 30: 42-52
- Body mass index and body surface area and their associations with outcomes in stage II and III colon cancer.J Gastrointest Cancer. 2013; 44: 203-210
- Impact of body mass index and weight change after treatment on cancer recurrence and survival in patients with stage III colon cancer: findings from Cancer and Leukemia Group B 89803.J Clin Oncol. 2008; 26: 4109-4115
- Outcomes among African-American/non-African-American patients with advanced non-small-cell lung carcinoma: report from the Cancer and Leukemia Group B.J Natl Cancer Inst. 2002; 94: 284-290
- Survival predictors in advanced non-small cell lung cancer.Lung Cancer. 1995; 13: 253-267
- Toxicity and response criteria of the Eastern Cooperative Oncology Group.Am J Clin Oncol. 1982; 5: 649-655
- The immediate cause of death in cancer.Am J Med Sci. 1932; 184: 610-613
- Physical activity and sedentary behavior of cancer survivors and non-cancer individuals: results from a national survey.PLoS One. 2013; 8: e57598
- NCCN practice guidelines for cancer-related fatigue.Oncology (Williston Park). 2000; 14: 151-161
- Stress and weight gain in parents of cancer patients.Int J Obes (Lond). 2005; 29: 244-250
- Physical activity in chronic fatigue syndrome: assessment and its role in fatigue.J Psychiatr Res. 1997; 31: 661-673
- Physical activity and diet behaviour in colorectal cancer patients receiving chemotherapy: associations with quality of life.BMC Gastroenterol. 2009; 9: 60
- Do patients with weight loss have a worse outcome when undergoing chemotherapy for lung cancers?.Br J Cancer. 2004; 90: 1905-1911
- Prognostic factors in advanced cancer patients: evidence-based clinical recommendations—a study by the Steering Committee of the European Association for Palliative Care.J Clin Oncol. 2005; 23: 6240-6248
- Prognostic factors in stage III non-small cell lung cancer: a review of conventional, metabolic and new biological variables.Ther Adv Med Oncol. 2011; 3: 127-138
- Muscle wasting in cancer cachexia: clinical implications, diagnosis, and emerging treatment strategies.Annu Rev Med. 2011; 62: 265-279
- Skeletal muscle strength as a predictor of all-cause mortality in healthy men.J Gerontol A Biol Sci Med Sci. 2002; 57: B359-B365
- Sarcopenia and mortality risk in frail older persons aged 80 years and older: results from ilSIRENTE study.Age Ageing. 2013; 42: 203-209
- The assessment and impact of sarcopenia in lung cancer: a systematic literature review.BMJ Open. 2014; 4: e003697
Published online: July 25, 2015
Accepted: July 20, 2015
Received in revised form: June 23, 2015
Received: March 26, 2015
© 2016 Elsevier Inc. Published by Elsevier Inc. All rights reserved.