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Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803.

Abstract

BACKGROUND

The influence of glycemic load and related measures on survival among colon cancer patients remains largely unknown.

METHODS

We conducted a prospective, observational study of 1011 stage III colon cancer patients reporting dietary intake during and 6 months after participation in an adjuvant chemotherapy trial. We examined the influence of glycemic load, glycemic index, fructose, and carbohydrate intakes on cancer recurrence and mortality using Cox proportional hazards regression; all tests of statistical significance were two-sided.

RESULTS

Stage III colon cancer patients in the highest quintile of dietary glycemic load experienced an adjusted hazard ratio (HR) for disease-free survival of 1.79 (95% confidence interval [CI] = 1.29 to 2.48), compared with those in the lowest quintile (P (trend) across quintiles <.001). Increased glycemic load was associated with similar detriments in recurrence-free (P (trend) across quintiles <.001) and overall survival (P (trend) across quintiles <.001). These associations differed statistically significant by body mass index (BMI) (P (interaction) =.01). Whereas glycemic load was not associated with disease-free survival in patients with BMI < 25kg/m(2), higher glycemic load was statistically significant associated with worse disease-free survival among overweight or obese participants (BMI ≥ 25kg/m(2); HR = 2.26; 95% CI = 1.53 to 3.32; P (trend) across quintiles <.001). Increasing total carbohydrate intake was similarly associated with inferior disease-free, recurrence-free, and overall survival (P (trend) across quintiles <.001).

CONCLUSION

Higher dietary glycemic load and total carbohydrate intake were statistically significant associated with an increased risk of recurrence and mortality in stage III colon cancer patients. These findings support the role of energy balance factors in colon cancer progression and may offer potential opportunities to improve patient survival.

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  • Authors+Show Affiliations

    ,

    Dana-Farber Cancer Institute, 450 Brookline Ave, Boston, MA 02215, USA. jmeyerhardt@partners.org

    , , , , , , , , , , ,

    Source

    Journal of the National Cancer Institute 104:22 2012 Nov 21 pg 1702-11

    MeSH

    Adult
    Aged
    Blood Glucose
    Body Mass Index
    Colonic Neoplasms
    Dietary Carbohydrates
    Dietary Sucrose
    Disease-Free Survival
    Energy Intake
    Female
    Follow-Up Studies
    Fructose
    Glycemic Index
    Humans
    Male
    Middle Aged
    Neoplasm Recurrence, Local
    Neoplasm Staging
    Odds Ratio
    Proportional Hazards Models
    Prospective Studies
    Randomized Controlled Trials as Topic
    Risk Factors
    Survival Analysis
    United States

    Pub Type(s)

    Journal Article
    Research Support, N.I.H., Extramural
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23136358

    Citation

    Meyerhardt, Jeffrey A., et al. "Dietary Glycemic Load and Cancer Recurrence and Survival in Patients With Stage III Colon Cancer: Findings From CALGB 89803." Journal of the National Cancer Institute, vol. 104, no. 22, 2012, pp. 1702-11.
    Meyerhardt JA, Sato K, Niedzwiecki D, et al. Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. J Natl Cancer Inst. 2012;104(22):1702-11.
    Meyerhardt, J. A., Sato, K., Niedzwiecki, D., Ye, C., Saltz, L. B., Mayer, R. J., ... Fuchs, C. S. (2012). Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. Journal of the National Cancer Institute, 104(22), pp. 1702-11. doi:10.1093/jnci/djs399.
    Meyerhardt JA, et al. Dietary Glycemic Load and Cancer Recurrence and Survival in Patients With Stage III Colon Cancer: Findings From CALGB 89803. J Natl Cancer Inst. 2012 Nov 21;104(22):1702-11. PubMed PMID: 23136358.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803. AU - Meyerhardt,Jeffrey A, AU - Sato,Kaori, AU - Niedzwiecki,Donna, AU - Ye,Cynthia, AU - Saltz,Leonard B, AU - Mayer,Robert J, AU - Mowat,Rex B, AU - Whittom,Renaud, AU - Hantel,Alexander, AU - Benson,Al, AU - Wigler,Devin S, AU - Venook,Alan, AU - Fuchs,Charles S, Y1 - 2012/11/07/ PY - 2012/11/9/entrez PY - 2012/11/9/pubmed PY - 2013/1/15/medline SP - 1702 EP - 11 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 104 IS - 22 N2 - BACKGROUND: The influence of glycemic load and related measures on survival among colon cancer patients remains largely unknown. METHODS: We conducted a prospective, observational study of 1011 stage III colon cancer patients reporting dietary intake during and 6 months after participation in an adjuvant chemotherapy trial. We examined the influence of glycemic load, glycemic index, fructose, and carbohydrate intakes on cancer recurrence and mortality using Cox proportional hazards regression; all tests of statistical significance were two-sided. RESULTS: Stage III colon cancer patients in the highest quintile of dietary glycemic load experienced an adjusted hazard ratio (HR) for disease-free survival of 1.79 (95% confidence interval [CI] = 1.29 to 2.48), compared with those in the lowest quintile (P (trend) across quintiles <.001). Increased glycemic load was associated with similar detriments in recurrence-free (P (trend) across quintiles <.001) and overall survival (P (trend) across quintiles <.001). These associations differed statistically significant by body mass index (BMI) (P (interaction) =.01). Whereas glycemic load was not associated with disease-free survival in patients with BMI < 25kg/m(2), higher glycemic load was statistically significant associated with worse disease-free survival among overweight or obese participants (BMI ≥ 25kg/m(2); HR = 2.26; 95% CI = 1.53 to 3.32; P (trend) across quintiles <.001). Increasing total carbohydrate intake was similarly associated with inferior disease-free, recurrence-free, and overall survival (P (trend) across quintiles <.001). CONCLUSION: Higher dietary glycemic load and total carbohydrate intake were statistically significant associated with an increased risk of recurrence and mortality in stage III colon cancer patients. These findings support the role of energy balance factors in colon cancer progression and may offer potential opportunities to improve patient survival. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/23136358/full_citation L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djs399 DB - PRIME DP - Unbound Medicine ER -