Grain Intake and Clinical Outcome in Stage III Colon Cancer: Results From CALGB 89803 (Alliance)

JNCI Cancer Spectrum

Zhang, Xuehong¹  Willett, Walter C¹  Brown, Justin C²  Ogino, Shuji²  Giovannucci, Edward L²  Mayer, Robert J²  Zhang, Sui²  Niedzwiecki, Donna³  Hantel, Alexander⁴  Li, Yanping⁵  Meyerhardt, Jeffrey A⁵  Fuchs, Charles S⁵  Ng, Kimmie⁵  Whittom, Renaud⁶  Saltz, Leonard B⁷  Benson, Al⁸  Messino, Michael⁹  Mowat, Rex B^1,10  Venook, Alan^1,11  Kindler, Hedy^1,12  Atienza, Daniel^1,13 

[1] Brigham and Women’s Hospital, Boston, MA;Dana-Farber/Partners CancerCare, Boston, MA;Duke Cancer Institute, Duke University Medical Center, Durham, NC;Edward-Elmhurst Heatlhcare, Naperville, IL;Harvard T.H. Chan School of Public Health, Boston, MA;Hôpital du Sacré-Coeur de Montréal Montreal, Canada;Memorial Sloan Kettering Cancer Center, New York, NY;Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL;Southeast Clinical Oncology Research (SCOR) Consortium, Mission Hospitals, Inc., Asheville, NC;Toledo Community Hospital Oncology Program, Toledo, OH;University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA;University of Chicago Comprehensive Cancer, Chicago, IL;Virginia Oncology Associates, Norfolk, VA

关键词: inflammation;    chemotherapy regimen;    treatment outcome;    colon cancer stage iii;    grain, whole;    cancer and leukemia group b;    follow-up;    hyperinsulinism;    diabetes mellitus, type 2;    primary outcome measure;   

DOI  :  10.1093/jncics/pky017

学科分类：肿瘤学

来源: Oxford University Press

【 摘 要 】

BackgroundEnergy balance–related risk factors for colon cancer recurrence and mortality—type II diabetes, hyperinsulinemia, inflammation, and visceral obesity—are positively correlated with consumption of refined grains and negatively correlated with consumption of whole grains. We examined the relationship between the consumption of refined and whole grains with cancer recurrence and mortality in a cohort of patients with colon cancer.MethodsWe conducted a prospective observational study of 1024 patients with stage III colon cancer who participated in a randomized trial of postoperative chemotherapy. Patients reported consumption of refined and whole grains using a food frequency questionnaire during and six months after chemotherapy. The primary outcome was disease-free survival (DFS). Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models. All P values are two-sided.ResultsDuring a median follow-up of 7.3 years, 394 patients experienced a DFS event. The hazard ratio for DFS was 1.56 (95% CI = 1.09 to 2.24) for patients consuming three or more servings per day of refined grains compared with patients consuming less than one serving per day (Ptrend = .005). The hazard ratio for DFS was 0.89 (95% CI = 0.66 to 1.20) for patients consuming three or more servings per day of whole grains compared with patients consuming less than one serving per day (Ptrend = .54). The hazard ratio for DFS of substituting one serving per day of refined grain with one serving per day of whole grain was 0.87 (95% CI = 0.79 to 0.96, P = .007).ConclusionsThe choice of grain consumed may be associated with cancer recurrence and mortality. Future studies are necessary to confirm our findings and to inform the design of randomized trials.

【 授权许可】

CC BY-NC-ND