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Leske M, Koczwara B, Blunt J, Morris J, Eakin E, Short CE, Daly A, Degner J, Beatty L. Co-designing Healthy Living after Cancer Online: an online nutrition, physical activity, and psychosocial intervention for post-treatment cancer survivors. J Cancer Surviv 2024; 18:606-616. [PMID: 36374435 PMCID: PMC9660094 DOI: 10.1007/s11764-022-01284-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022]
Abstract
PURPOSE The aim of the present study was to co-design Healthy Living after Cancer Online (HLaC Online), an online intervention supporting cancer survivors to set and meet their healthy living goals. METHODS Adapted from an initial telephone-delivered Healthy Living after Cancer program, wireframes (PDF black and white mock-ups) of the proposed online program were presented in a series of focus groups and interviews to our stakeholder group, which consisted of cancer survivors, oncology healthcare professionals, and representatives from cancer support organisations. Stakeholders were prompted for feedback on the wireframe and given end-user scenarios to encourage deeper engagement with the co-design process. Transcriptions underwent thematic analysis to determine which features of the program needed change or expansion. RESULTS 27 participants took part in one of 8 focus groups or 10 interviews. Five themes were identified relating to (a) website design elements, (b) promoting and maintaining long-term engagement, (c) relatability and relevance, (d) navigating professional support, and (e) family and peer support. Recommended changes, such as simple activities and guidance videos, were integrated into the HLaC Online prototype. CONCLUSIONS Involving end-users in the co-design process ensured the intervention's relevance and specificity to the needs of cancer survivors. Next steps include feasibility testing the prototype, prior to commencing a national randomised control trial of HLaC Online. IMPLICATIONS FOR CANCER SURVIVORS HLaC Online aims to support cancer survivors to improve their quality of life by making healthy lifestyle changes in their physical activity, healthy eating, weight management, mental health, and fatigue management.
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Affiliation(s)
- Morgan Leske
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia.
| | - Bogda Koczwara
- College of Medicine and Public Health, Flinders University, Adelaide, SA, Australia
- Department of Medical Oncology, Southern Adelaide Local Health Network, Adelaide, SA, Australia
| | | | | | - Elizabeth Eakin
- School of Public Health, Faculty of Medicine, University of Queensland, Brisbane, QLD, Australia
| | - Camille E Short
- Melbourne Centre for Behaviour Change, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Melbourne, VIC, Australia
| | | | - Jon Degner
- Cancer Voices South Australia, Kensington Park, SA, Australia
| | - Lisa Beatty
- College of Education, Psychology, and Social Work, Flinders University, Adelaide, SA, Australia
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Huang X, Du S, Wang Q, Yang C, Liu X, Chen K, Zhao Y, He N, Wang H. Impact of obese patients in ovarian cancer surgery on postoperative wound complications: A meta-analysis. Int Wound J 2024; 21:e14439. [PMID: 38064172 PMCID: PMC10957721 DOI: 10.1111/iwj.14439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Revised: 09/23/2023] [Accepted: 10/02/2023] [Indexed: 03/23/2024] Open
Abstract
The effect of obesity on wound-related outcomes in post-ovarian cancer patients is not clear. A number of studies on the association of fat with post-operation injury in ovarian carcinoma have produced contradictory findings. This study aims to conduct a study of the available data to assess the association of obese individuals with significant surgery results in ovarian cancer. We looked up Cochrane Library, Embase, and PubMed for qualifying research on ovarian cancer operations to determine the primary evidence for evaluating the association of obesity with post-surgical wound injury in ovarian cancer. The odds ratio (OR) was analysed with a fixed effect model if the variability of the study was small; otherwise, the analysis of the data was done with a random effect model. Out of 1259 related trials which were reviewed for eligibility, 6 publications were chosen from 2009 to 2019, 3076 patients who had had an operation for ovarian cancer. Obesity has been linked to an increased rate of wound-related complications in ovarian cancer operations compared to those without obesity (OR, 0.50; 95% CI, 0.37, 0.69 p < 0.0001). Non-obesity was significantly less likely to occur with respect to operation time compared to those with obesity (MD, -48.00; 95% CI, -55.33, -40.68 p < 0.00001). There were no statistically significant differences in the rate of haemorrhage after the operation (OR, 0.26; 95% CI, 0.04, 1.57, p = 0.14). Because of the limited number of trials in this meta-analysis, caution should be exercised in their treatment. More high-quality research with a large sample is required in order to confirm the findings.
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Affiliation(s)
- Xianxia Huang
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Shengye Du
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Qun Wang
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Chenchen Yang
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Xueling Liu
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Kai Chen
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Yinghui Zhao
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Ning He
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
| | - Hongping Wang
- Department of Gynaecology and ObstetricsJinan City People's HospitalJinanChina
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3
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Kocak MZ, Coban S, Araz M, Eryilmaz MK, Artac M. Prognostic biomarkers in metastatic colorectal cancer: delta prognostic nutritional index, delta neutrophil to lymphocyte ratio, and delta platelet to lymphocyte ratio. Support Care Cancer 2023; 31:357. [PMID: 37246994 DOI: 10.1007/s00520-023-07829-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 05/22/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND The aim of this study is to determine the prognostic value of the prognostic nutritional index (PNI), the neutrophil to lymphocyte ratio (NLR), and the platelet to lymphocyte ratio (PLR) and their dynamic changes on survival outcomes in metastatic colorectal cancers (mCRC). METHODS The data of 199 patients with mCRC were retrospectively analyzed. To evaluate the temporal relation between the PNI, NLR, and PLR values and survival, pre-chemotherapy PNI, NLR, and PLR levels were assessed from peripheral blood cell counts on admission; post-chemotherapy PNI, NLR, and PLR levels were assessed with follow-up blood cell counts within two weeks after chemotherapy; and the difference between pre-chemotherapy PNI, NLR, and PLR levels and post-chemotherapy PNI, NLR, and PLR levels was evaluated as delta PNI, delta NLR, and delta PLR. RESULTS The median PNI, PLR, and NLR were 39.01, 150.2 and 2.53 before chemotherapy and 38.2, 146.6, and 3.31 after chemotherapy, respectively. The median OS was 23.7 months (95%CI:17.8-29.7) and 28.9 months (95%CI:24.8-33.08) for pre-chemotherapy PNI level < 39.01 vs. PNI level ≥ 39.01, respectively(p = 0.035) The positive delta PNI was significantly higher for OS than the negative delta PNI(p < 0.009). Delta PLR and delta NLR were not significant for OS and PFS(p > 0.05 for all). CONCLUSIONS The results of this study clearly show that the negative delta PNI to be an independent predictor of poor OS and poor PFS in patients with colon cancer who received first line treatment. In addition, delta NLR and delta PLR were shown not to predict survival outcomes.
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Affiliation(s)
- Mehmet Zahid Kocak
- Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey.
| | - Seda Coban
- Department of Internal Medicine, Necmettin Erbakan University, Konya, Turkey
| | - Murat Araz
- Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
| | | | - Mehmet Artac
- Department of Medical Oncology, Necmettin Erbakan University, Konya, Turkey
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Himbert C, Ose J, Gigic B, Viskochil R, Santuci K, Lin T, Ashworth A, Cohan JN, Scaife CL, Jedrzkiewicz J, Damerell V, Atkins KM, Gong J, Mutch MG, Bernadt C, Felder S, Sanchez J, Cohen SA, Krane MK, Hinkle N, Wood E, Peoples AR, Figueiredo JC, Toriola AT, Siegel EM, Li CI, Shibata D, Boucher K, Round JL, Ulrich AB, Schneider M, Huang LC, Hardikar S, Ulrich CM. Associations of combined physical activity and body mass index groups with colorectal cancer survival outcomes. BMC Cancer 2023; 23:300. [PMID: 37013476 PMCID: PMC10069054 DOI: 10.1186/s12885-023-10695-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 03/01/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Physical activity and BMI have been individually associated with cancer survivorship but have not yet been studied in combinations in colorectal cancer patients. Here, we investigate individual and combined associations of physical activity and BMI groups with colorectal cancer survival outcomes. METHODS Self-reported physical activity levels (MET hrs/wk) were assessed using an adapted version of the International Physical Activity Questionnaire (IPAQ) at baseline in 931 patients with stage I-III colorectal cancer and classified into 'highly active' and'not-highly active'(≥ / < 18 MET hrs/wk). BMI (kg/m2) was categorized into 'normal weight', 'overweight', and 'obese'. Patients were further classified into combined physical activity and BMI groups. Cox-proportional hazard models with Firth correction were computed to assess associations [hazard ratio (HR), 95% profile HR likelihood confidence interval (95% CI) between individual and combined physical activity and BMI groups with overall and disease-free survival in colorectal cancer patients. RESULTS 'Not-highly active' compared to 'highly active' and 'overweight'/ 'obese' compared to 'normal weight' patients had a 40-50% increased risk of death or recurrence (HR: 1.41 (95% CI: 0.99-2.06), p = 0.03; HR: 1.49 (95% CI: 1.02-2.21) and HR: 1.51 (95% CI: 1.02-2.26), p = 0.04, respectively). 'Not-highly active' patients had worse disease-free survival outcomes, regardless of their BMI, compared to 'highly active/normal weight' patients. 'Not-highly active/obese' patients had a 3.66 times increased risk of death or recurrence compared to 'highly active/normal weight' patients (HR: 4.66 (95% CI: 1.75-9.10), p = 0.002). Lower activity thresholds yielded smaller effect sizes. CONCLUSION Physical activity and BMI were individually associated with disease-free survival among colorectal cancer patients. Physical activity seems to improve survival outcomes in patients regardless of their BMI.
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Affiliation(s)
- Caroline Himbert
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Jennifer Ose
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | - Richard Viskochil
- University of Utah, Salt Lake City, UT, USA
- University of Massachusetts Boston, Boston, MA, USA
| | | | - Tengda Lin
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | - Jessica N Cohan
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Courtney L Scaife
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Jolanta Jedrzkiewicz
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | | | - Jun Gong
- Cedars-Sinai Medical Center, Los Angeles, CA, USA
| | - Matthew G Mutch
- Washington University School of Medicine, St. Louis, MO, USA
| | - Corey Bernadt
- Washington University School of Medicine, St. Louis, MO, USA
| | - Seth Felder
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Julian Sanchez
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Stacey A Cohen
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, USA
| | - Mukta K Krane
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, USA
| | - Nathan Hinkle
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Elizabeth Wood
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Anita R Peoples
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | | | - Erin M Siegel
- H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA
| | - Christopher I Li
- Fred Hutchinson Cancer Center, University of Washington, Seattle, WA, USA
| | - David Shibata
- University of Tennessee Health Science Center, Memphis, TN, USA
| | - Kenneth Boucher
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | | | | | | | - Lyen C Huang
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Sheetal Hardikar
- University of Utah, Salt Lake City, UT, USA
- Huntsman Cancer Institute, Salt Lake City, UT, USA
| | - Cornelia M Ulrich
- University of Utah, Salt Lake City, UT, USA.
- Huntsman Cancer Institute, Salt Lake City, UT, USA.
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5
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Zhang Z, Yan X, Lu Y, Guo X, Jiao M, Wang W, Sun B, Zhou Y, Hu Q, Chu D. The prognostic impact of BMI on colorectal cancer is stratified by tumor location. Front Oncol 2022; 12:987518. [PMID: 36419882 PMCID: PMC9677941 DOI: 10.3389/fonc.2022.987518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 10/10/2022] [Indexed: 11/09/2022] Open
Abstract
Purpose Recent studies have revealed the contrasting prognostic roles of body mass index (BMI) and tumor location in colorectal cancer (CRC). Given that right- and left-sided CRC may exhibit inverse effects on outcome and body weight, the present study aimed to examine whether the prognostic value of BMI and tumor location could be reciprocally stratified. Methods This prospective, observational study recruited 4,086 patients diagnosed with stage III CRC from five independent clinical centers in China. The association of patients’ outcomes with BMI and tumor location was evaluated hierarchically by Kaplan–Meier and Cox proportional-hazards models. Results Although BMI was not associated with overall outcome, the association was significantly modified by tumor location. Among left-sided tumors, obesity and overweight were significantly associated with adverse overall survival (OS) and disease-specific survival (DSS). In contrast, among right-sided tumors, overweight was significantly associated with more favorable OS and DSS compared with the normal-weight group. The association of survival with tumor location did not reach statistical significance. However, hierarchical analysis by BMI revealed that left-sided tumors were associated with more favorable outcomes in the normal-weight group, while there was no statistically significant difference in the overweight or obese group. Conclusions BMI and tumor location may have opposing effects on CRC prognosis, when stratified by each other, after adjusting for other known prognostic factors. These findings are the first to show the interactive prognostic impact of BMI and tumor location, which could be relevant to the stratification of patient management.
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Affiliation(s)
- Zixi Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xueli Yan
- Department of Gastroenterology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yan Lu
- Department of Gastroenterology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Xiaowen Guo
- Department of Gastroenterology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Min Jiao
- Department of Oncology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Weizhong Wang
- State Key Laboratory of Cancer Biology, Department of Gastrointestinal Surgery, Xijing Hospital of Digestive Diseases, Air Force Medical University, Xi’an, China
| | - Boqian Sun
- Department of Hospital Management, Affiliated Hospital of Beihua University, Jilin, China
| | - Yi Zhou
- Department of Gastrointestinal Surgery, Tianjin People’s Hospital, Tianjin, China
| | - Qinglin Hu
- Department of General Surgery, The First Affiliated Hospital of Chengdu Medical College, Chengdu, China
| | - Dake Chu
- Department of Gastroenterology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Dake Chu,
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6
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Cheng E, Ou FS, Ma C, Spiegelman D, Zhang S, Zhou X, Bainter TM, Saltz LB, Niedzwiecki D, Mayer RJ, Whittom R, Hantel A, Benson A, Atienza D, Messino M, Kindler H, Giovannucci EL, Van Blarigan EL, Brown JC, Ng K, Gross CP, Meyerhardt JA, Fuchs CS. Diet- and Lifestyle-Based Prediction Models to Estimate Cancer Recurrence and Death in Patients With Stage III Colon Cancer (CALGB 89803/Alliance). J Clin Oncol 2022; 40:740-751. [PMID: 34995084 PMCID: PMC8887946 DOI: 10.1200/jco.21.01784] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 10/08/2021] [Accepted: 12/06/2021] [Indexed: 12/12/2022] Open
Abstract
PURPOSE Current tools in predicting survival outcomes for patients with colon cancer predominantly rely on clinical and pathologic characteristics, but increasing evidence suggests that diet and lifestyle habits are associated with patient outcomes and should be considered to enhance model accuracy. METHODS Using an adjuvant chemotherapy trial for stage III colon cancer (CALGB 89803), we developed prediction models of disease-free survival (DFS) and overall survival by additionally incorporating self-reported nine diet and lifestyle factors. Both models were assessed by multivariable Cox proportional hazards regression and externally validated using another trial for stage III colon cancer (CALGB/SWOG 80702), and visual nomograms of prediction models were constructed accordingly. We also proposed three hypothetical scenarios for patients with (1) good-risk, (2) average-risk, and (3) poor-risk clinical and pathologic features, and estimated their predictive survival by considering clinical and pathologic features with or without adding self-reported diet and lifestyle factors. RESULTS Among 1,024 patients (median age 60.0 years, 43.8% female), we observed 394 DFS events and 311 deaths after median follow-up of 7.3 years. Adding self-reported diet and lifestyle factors to clinical and pathologic characteristics meaningfully improved performance of prediction models (c-index from 0.64 [95% CI, 0.62 to 0.67] to 0.69 [95% CI, 0.67 to 0.72] for DFS, and from 0.67 [95% CI, 0.64 to 0.70] to 0.71 [95% CI, 0.69 to 0.75] for overall survival). External validation also indicated good performance of discrimination and calibration. Adding most self-reported favorable diet and lifestyle exposures to multivariate modeling improved 5-year DFS of all patients and by 6.3% for good-risk, 21.4% for average-risk, and 42.6% for poor-risk clinical and pathologic features. CONCLUSION Diet and lifestyle factors further inform current recurrence and survival prediction models for patients with stage III colon cancer.
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Affiliation(s)
- En Cheng
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
- Division of Research, Kaiser Permanente Northern California, Oakland, CA
| | - Fang-Shu Ou
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN
| | - Chao Ma
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Donna Spiegelman
- Department of Biostatistics, Yale School of Public Health, New Haven, CT
- Center on Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, CT
| | - Sui Zhang
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Xin Zhou
- Department of Biostatistics, Yale School of Public Health, New Haven, CT
- Center on Methods for Implementation and Prevention Science, Yale School of Public Health, New Haven, CT
| | - Tiffany M. Bainter
- Alliance Statistics and Data Management Center, Mayo Clinic, Rochester, MN
| | | | - Donna Niedzwiecki
- Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, NC
| | - Robert J. Mayer
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Renaud Whittom
- Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada
| | | | - Al Benson
- Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago, IL
| | | | | | | | - Edward L. Giovannucci
- Department of Epidemiology, and Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Erin L. Van Blarigan
- Department of Epidemiology and Biostatistics, and Urology, University of California, San Francisco, CA
| | - Justin C. Brown
- Cancer Metabolism Program, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Kimmie Ng
- Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA
| | - Cary P. Gross
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
- Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT
- Cancer Outcomes, Public Policy, and Effectiveness Research Center, Yale Cancer Center, New Haven, CT
| | | | - Charles S. Fuchs
- Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Yale School of Medicine, New Haven, CT
- Yale Cancer Center, Smilow Cancer Hospital, New Haven, CT
- Hematology and Oncology Product Development, Genentech & Roche, South San Francisco, CA
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Chiu CC, Ho CH, Hung CM, Chao CM, Lai CC, Chen CM, Liao KM, Wang JJ, Wu YC, Shi HY, Lee PH, Lee HM, Yeh LR, Soong TC, Chiang SR, Cheng KC. Correlation of Body Mass Index with Oncologic Outcomes in Colorectal Cancer Patients: A Large Population-Based Study. Cancers (Basel) 2021; 13:cancers13143592. [PMID: 34298805 PMCID: PMC8307410 DOI: 10.3390/cancers13143592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 07/07/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023] Open
Abstract
It has been acknowledged that excess body weight increases the risk of colorectal cancer (CRC); however, there is little evidence on the impact of body mass index (BMI) on CRC patients' long-term oncologic results in Asian populations. We studied the influence of BMI on overall survival (OS), disease-free survival (DFS), and CRC-specific survival rates in CRC patients from the administrative claims datasets of Taiwan using the Kaplan-Meier survival curves and the log-rank test to estimate the statistical differences among BMI groups. Underweight patients (<18.50 kg/m2) presented higher mortality (56.40%) and recurrence (5.34%) rates. Besides this, they had worse OS (aHR:1.61; 95% CI: 1.53-1.70; p-value: < 0.0001) and CRC-specific survival (aHR:1.52; 95% CI: 1.43-1.62; p-value: < 0.0001) rates compared with those of normal weight patients (18.50-24.99 kg/m2). On the contrary, CRC patients belonging to the overweight (25.00-29.99 kg/m2), class I obesity (30.00-34.99 kg/m2), and class II obesity (≥35.00 kg/m2) categories had better OS, DFS, and CRC-specific survival rates in the analysis than the patients in the normal weight category. Overweight patients consistently had the lowest mortality rate after a CRC diagnosis. The associations with being underweight may reflect a reverse causation. CRC patients should maintain a long-term healthy body weight.
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Affiliation(s)
- Chong-Chi Chiu
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan; (C.-C.C.); (C.-M.H.); (H.-M.L.)
- School of Medicine, College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan
| | - Chung-Han Ho
- Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan; (C.-H.H.); (Y.-C.W.)
- Cancer Center, Wan Fang Hospital, Taipei Medical University, Taipei 11695, Taiwan
- Department of Information Management, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
| | - Chao-Ming Hung
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan; (C.-C.C.); (C.-M.H.); (H.-M.L.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; (P.-H.L.); (T.-C.S.)
| | - Chien-Ming Chao
- Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying 73657, Taiwan;
- Department of Dental Laboratory Technology, Min-Hwei College of Health Care Management, Tainan 73657, Taiwan
| | - Chih-Cheng Lai
- Department of Internal Medicine, Kaohsiung Veterans General Hospital, Tainan Branch, Tainan 71004, Taiwan;
| | - Chin-Ming Chen
- Department of Intensive Care Medicine, Chi-Mei Medical Center, Tainan 71004, Taiwan;
| | - Kuang-Ming Liao
- Department of Internal Medicine, Chi Mei Medical Center, Chiali 72263, Taiwan;
| | - Jhi-Joung Wang
- Department of Anesthesiology, Chi Mei Medical Center, Tainan 71004, Taiwan;
- Department of Anesthesiology, National Defense Medical Center, Taipei 11490, Taiwan
| | - Yu-Cih Wu
- Department of Medical Research, Chi Mei Medical Center, Tainan 71004, Taiwan; (C.-H.H.); (Y.-C.W.)
| | - Hon-Yi Shi
- Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung 80708, Taiwan;
- Department of Business Management, National Sun Yat-Sen University, Kaohsiung 80424, Taiwan
- Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung 80756, Taiwan
- Department of Medical Research, China Medical University Hospital, China Medical University, Taichung 40402, Taiwan
| | - Po-Huang Lee
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; (P.-H.L.); (T.-C.S.)
- Department of Surgery, E-Da Hospital, Kaohsiung 82445, Taiwan
| | - Hui-Ming Lee
- Department of General Surgery, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan; (C.-C.C.); (C.-M.H.); (H.-M.L.)
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; (P.-H.L.); (T.-C.S.)
| | - Li-Ren Yeh
- Department of Anesthesiology, E-Da Cancer Hospital, Kaohsiung 82445, Taiwan;
- Department of Medical Imaging and Radiology, Shu-Zen Junior College of Medicine and Management, Kaohsiung 82144, Taiwan
| | - Tien-Chou Soong
- College of Medicine, I-Shou University, Kaohsiung 82445, Taiwan; (P.-H.L.); (T.-C.S.)
- Weight Loss and Health Management Center, E-Da Dachang Hospital, Kaohsiung 80794, Taiwan
| | - Shyh-Ren Chiang
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan;
- Department of General Education, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
| | - Kuo-Chen Cheng
- Department of Internal Medicine, Chi Mei Medical Center, Tainan 71004, Taiwan;
- Department of Safety, Health and Environment, Chung Hwa University of Medical Technology, Tainan 71703, Taiwan
- Correspondence: ; Tel.: +886-933672369; Fax: +886-6-2828928
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Increases in adipose tissue and muscle function are longitudinally associated with better quality of life in colorectal cancer survivors. Sci Rep 2021; 11:12440. [PMID: 34127719 PMCID: PMC8203762 DOI: 10.1038/s41598-021-91709-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 05/24/2021] [Indexed: 12/26/2022] Open
Abstract
Colorectal cancer (CRC) survivors need evidence-based guidelines pertaining to post-treatment body composition, which could benefit health-related quality of life (HRQoL). We aimed to describe the course of several body composition measures, and to assess longitudinal associations of these measures with HRQoL, fatigue and chemotherapy-induced peripheral neuropathy (CIPN). In a prospective cohort among stage I–III CRC survivors (n = 459), five repeated home visits from diagnosis up to 24 months post-treatment were executed. Body mass index (BMI), waist circumference and fat percentage were assessed as measures of adiposity, and muscle arm circumference and handgrip strength as measures of muscle mass and function. We applied linear mixed-models to describe changes in body composition over time and to analyze overall longitudinal associations. Of included participants, 44% was overweight and 31% was obese at diagnosis. All body composition measures followed similar trends, decreasing from diagnosis to 6 weeks and then increasing up to 24 months post-treatment. In confounder-adjusted mixed models, increases in adipose tissue and muscle function were longitudinally associated with better HRQoL and less fatigue, regardless of pre-treatment body composition. With regards to improving HRQoL, decreasing fatigue and CIPN, clinical practice should also focus on restoring body tissues after CRC treatment. Trial registration: NTR7099.
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9
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Basile D, Bartoletti M, Polano M, Bortot L, Gerratana L, Di Nardo P, Borghi M, Fanotto V, Pelizzari G, Lisanti C, Garutti M, Buriolla S, Ongaro E, Andreuzzi E, Montico M, Balestreri L, Miolo G, Toffoli G, Aprile G, Puglisi F, Buonadonna A. Prognostic role of visceral fat for overall survival in metastatic colorectal cancer: A pilot study. Clin Nutr 2021; 40:286-294. [DOI: 10.1016/j.clnu.2020.05.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Revised: 04/29/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023]
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10
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Karabulut S, Dogan I, Usul Afsar C, Karabulut M, Karaman S, Ferhatoglu F, Tastekin D. Does nutritional status affect treatment tolarability, response and survival in metastatic colorectal cancer patients? Results of a prospective multicenter study. J Oncol Pharm Pract 2020; 27:1357-1363. [PMID: 32957862 DOI: 10.1177/1078155220959427] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
BACKGROUND The efficacy and tolerability of modern cytotoxic chemotherapy regimens used in malnourished metastatic colorectal cancer (mCRC) patients is uncertain. The aim of this study was to investigate the effect of malnutrition on efficacy and tolerability of cytotoxic chemotherapy and overall survival in mCRC patients. METHODS In this multicenter study, demographic, oncologic and nutritional data were collected prospectively from mCRC patients. Nutritional status of the patients were evaluated on the basis of NRI (Nutritional Risk Assessment), BMI (Body Mass Index) and WL (Weight Loss) before the first chemotherapy, after the first and second chemotherapy during 2 cycles of chemotherapy every 15 days. To determine the inter-treatment weight loss toxicity assessment was included to theese parameters after each chemotherapy. NRI calculation was performed as [1.51xserum albumin level (g/L)+41.7xcurrent weight/basic weight]. NRIs were examined in 3 categories as 'no malnutrition' (NRI >97.5), 'moderate malnutrition' (97.5 ≥NRI ≥83.5) or 'severe malnutrition' (NRI <83.5). Response to treatment and drug-induced toxicities were assessed based on Criteria in Solid Tumors (RECIST) 1.1 and National Cancer Institute CTCAE version 4.0 respectively. RESULTS One-hundred and thirty-seven mCRC patients were prospectively included. Median age was 48 (range 18-83). Primary location was colon in 66% of patients and 84% of their primary source was left colon. Malnutrition was detected in 39% of the cases. Response rate to treatment was twenty four percent. While there was no significant relationship between chemotherapy response and moderate/severe malnutrition (p = 0.24), moderate/severe malnutrition was associated with multipl site of metastases, WHO PS (World Health Organization Performance Status) of 1, over the median value of CEA/CA 19-9 (carcinoembryonic antigen/carbohydate antigen 19-9) levels (p = 0.003, p = 0.03, p < 0.001, and p = 0.02; respectively). Hypoalbuminemia and moderate/severe malnutrition were associated with all types of toxicity (p < 0.001 and p < 0.001). Moderate/severe malnutrition was associated with thrombocytopenia, and diarrhea following chemotherapy predominately, (p = 0.02 and p = 0.04; respectively). In moderate/severe malnutrition group median overall survival was prominently shorter than those with no malnutrition [6.6 moths (95%CI, 5.6-7.6) vs 11.9 moths (95% CI, 11.1-12.7) respectively, p < 0.001]. CONCLUSIONS Our study showed that moderate/severe malnutrition in mCRC patients was associated with decreased overall survival and increased chemotherapy toxicity.
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Affiliation(s)
- Senem Karabulut
- Department of Medical Oncology, Institute of Oncology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Izzet Dogan
- Department of Medical Oncology, Institute of Oncology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Cigdem Usul Afsar
- Department of Internal Medicine and Medical Oncology, Research and Practice Hospital, Balıkesir University, Balıkesir, Turkey
| | - Mehmet Karabulut
- Department of General Surgery, Bakırkoy Dr Sadi Konuk Education and Research Hospital, Health Sciences University, Istanbul, Turkey
| | - Sule Karaman
- Department of Radiation Oncology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ferhat Ferhatoglu
- Department of Medical Oncology, Institute of Oncology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Didem Tastekin
- Department of Medical Oncology, Institute of Oncology, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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11
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A clinical prediction nomogram to assess risk of colorectal cancer among patients with type 2 diabetes. Sci Rep 2020; 10:14359. [PMID: 32873885 PMCID: PMC7463255 DOI: 10.1038/s41598-020-71456-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 08/12/2020] [Indexed: 12/24/2022] Open
Abstract
Colorectal cancer remains a major health burden worldwide and is closely related to type 2 diabetes. This study aimed to develop and validate a colorectal cancer risk prediction model to identify high-risk individuals with type 2 diabetes. Records of 930 patients with type 2 diabetes were reviewed and data were collected from 1 November 2013 to 31 December 2019. Clinical and demographic parameters were analyzed using univariable and multivariable logistic regression analysis. The nomogram to assess the risk of colorectal cancer was constructed and validated by bootstrap resampling. Predictors in the prediction nomogram included age, sex, other blood-glucose-lowering drugs and thiazolidinediones. The nomogram demonstrated moderate discrimination in estimating the risk of colorectal cancer, with Hosmer-Lemeshow test P = 0.837, an unadjusted C-index of 0.713 (95% CI 0.670-0.757) and a bootstrap-corrected C index of 0.708. In addition, the decision curve analysis demonstrated that the nomogram would be clinically useful. We have developed a nomogram that can predict the risk of colorectal cancer in patients with type 2 diabetes. The nomogram showed favorable calibration and discrimination values, which may help clinicians in making recommendations about colorectal cancer screening for patients with type 2 diabetes.
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12
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Minami Y, Kanemura S, Oikawa T, Suzuki S, Hasegawa Y, Nishino Y, Fujiya T, Miura K. Associations of Japanese food intake with survival of stomach and colorectal cancer: A prospective patient cohort study. Cancer Sci 2020; 111:2558-2569. [PMID: 32412140 PMCID: PMC7385343 DOI: 10.1111/cas.14459] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/09/2020] [Accepted: 05/11/2020] [Indexed: 02/07/2023] Open
Abstract
Dietary factors may affect the prognosis of digestive tract cancer, but evidence has been sparse. We investigated the association between pretreatment intake of 6 Japanese foods (including soy food, miso [soybean paste] soup and seaweed) and the risk of death among patients with histologically confirmed major digestive tract cancers (stomach, 1931; colon, 793; rectum, 510) diagnosed during 1997‐2013 at a single institution in Japan. Pretreatment dietary intake was assessed using a food frequency questionnaire, and the patients were followed until December 2016. The Cox proportional hazards model was used to estimate hazard ratios (HR) and 95% confidence intervals (CI). Among the patients with stomach cancer, frequent intake of soy food was inversely associated with the risk of all‐cause (Ptrend for four frequency groups = 0.01; HR = 0.72, 95% CI: 0.50‐1.04 for highest vs lowest group) and stomach cancer (Ptrend = 0.03; HR = 0.63, 95% CI: 0.40‐0.99) death. A similar inverse association was also found for intake of miso soup. In contrast, frequent seaweed intake was inversely associated with the risk of all‐cause death among the patients with colon cancer (Ptrend = 0.03). Rectal cancer patients who had frequently consumed seaweed tended to have a lower risk of rectal cancer death (Ptrend = 0.02). These findings indicate that pretreatment intake of Japanese foods such as soybean products and seaweed may have favorable effects on patient survival of stomach and colorectal cancer, although this needs to be confirmed by further research.
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Affiliation(s)
- Yuko Minami
- Department of Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan.,Division of Cancer Epidemiology and Prevention, Miyagi Cancer Center Research Institute, Natori, Japan.,Center for Preventive Medicine, Osaki Citizen Hospital, Osaki, Japan
| | - Seiki Kanemura
- Division of Cancer Epidemiology and Prevention, Miyagi Cancer Center Research Institute, Natori, Japan
| | - Tomoyuki Oikawa
- Department of Gastroenterology, Miyagi Cancer Center Hospital, Natori, Japan
| | - Shinichi Suzuki
- Department of Gastroenterology, Miyagi Cancer Center Hospital, Natori, Japan
| | | | - Yoshikazu Nishino
- Department of Epidemiology and Public Health, Kanazawa Medical University, Kahoku, Japan
| | - Tsuneaki Fujiya
- Department of Surgery, Miyagi Cancer Center Hospital, Natori, Japan
| | - Koh Miura
- Department of Surgery, Miyagi Cancer Center Hospital, Natori, Japan
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Tabatabaie S, Litt JS, Crane LA. The experience of outdoor physical activity for skin cancer survivors: understanding the importance of the built and natural environments. J Cancer Surviv 2020; 14:739-756. [PMID: 32506221 DOI: 10.1007/s11764-020-00889-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2019] [Accepted: 04/28/2020] [Indexed: 11/30/2022]
Abstract
PURPOSE Cancer patients are encouraged to do more physical activity (PA). Exercising in outdoor settings, however, may expose people to UV radiation, which is the main risk factor of melanoma. This study aimed to understand how melanoma diagnoses affect people's perception of the outdoor environment for PA. METHOD In-depth interviews were conducted among 19 individuals (20-85 years) with a history of melanoma at a skin cancer clinic in the Denver metropolitan area. Transcribed interviews were coded for emergent themes. The coding framework included topics related to PA behavior, sun protection, and perceptions of outdoor environment. RESULTS Respondents reported no change in their level of outdoor activity after the melanoma diagnosis; they tried to reduce the risk of sun exposure by using sunscreen and sun-protective clothing. They also reported seeking shade, trees, and groundcover along urban corridors, in order to avoid sun exposure, reflective surfaces, and heat while being active outdoors. CONCLUSION Given the public health significance of UV exposure and extreme heat, further investments should be made to craft streetscape design guidelines and implement sun-proof spaces across public facilities, including parks, schools, and sport fields in order to ameliorate environmental risks for skin cancer survivors, to prevent future cancers among those that are vulnerable to the hazards of excessive UV exposure and extreme heat, and to promote outdoor PA. IMPLICATIONS FOR CANCER SURVIVORS Skin cancer survivors and other vulnerable population subgroups will benefit from discussions around neighborhood-based design interventions that promote PA while accounting for sun safety.
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Affiliation(s)
- S Tabatabaie
- The Program in Environmental Design, University of Colorado Boulder, Boulder, CO, USA.
| | - J S Litt
- The Environmental Studies Program, University of Colorado Boulder, Boulder, CO, USA
| | - L A Crane
- Colorado School of Public Health, Boulder, CO, USA
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Romero-Elías M, Beltrán-Carrillo VJ, González-Cutre D, Jiménez-Loaisa A. Barriers to physical activity participation in colorectal cancer patients during chemotherapy treatment: A qualitative study. Eur J Oncol Nurs 2020; 46:101769. [PMID: 32506009 DOI: 10.1016/j.ejon.2020.101769] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/29/2020] [Accepted: 05/08/2020] [Indexed: 01/10/2023]
Abstract
PURPOSE To explore the barriers that colorectal cancer patients (stage II and III) perceive to participate in physical activity (PA) when involved in adjuvant chemotherapy. Views of relatives and physicians concerning this issue were also included. METHOD Qualitative data from ten patients, ten relatives, and ten health professionals were obtained through semi-structured interviews (n = 30). RESULTS Two main themes were identified after data analysis: (a) barriers to PA related to ostomy and adjuvant chemotherapy and (b) barriers related to perceived lack of support for PA. In regard to the first theme, participants reported difficulties associated with the ostomy, limitations of the intravenous chemotherapy device, fatigue and reduced physical fitness, and focusing on cancer and restructuring priorities. Concerning the perceived lack of support for PA, participants referred to their families' overprotection, the health professionals' lack of knowledge and time to prescribe PA, and the lack of PA services in health centres. CONCLUSIONS Further information from health professionals about the recommendations of PA and its benefits during adjuvant chemotherapy could palliate these PA barriers. The offer of specific PA programmes for these patients is also recommended.
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Affiliation(s)
- María Romero-Elías
- Department of Sport Sciences. Sport Research Centre. Miguel Hernández University of Elche, Spain.
| | | | - David González-Cutre
- Department of Sport Sciences. Sport Research Centre. Miguel Hernández University of Elche, Spain.
| | - Alejandro Jiménez-Loaisa
- Department of Sport Sciences. Sport Research Centre. Miguel Hernández University of Elche, Spain.
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Meeting Minimum ESPEN Energy Recommendations Is Not Enough to Maintain Muscle Mass in Head and Neck Cancer Patients. Nutrients 2019; 11:nu11112743. [PMID: 31726711 PMCID: PMC6893412 DOI: 10.3390/nu11112743] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Revised: 10/25/2019] [Accepted: 11/05/2019] [Indexed: 02/06/2023] Open
Abstract
The relationship between dietary intake and body composition changes during cancer treatment has not been well characterized. The aim of this study was to compare dietary intake at diagnosis and end of treatment in relation to changes in muscle mass and adiposity in head and neck cancer (HNC) patients. Dietary intakes (three-day food record) and body composition using computed tomography (CT) were assessed at diagnosis (baseline) and after treatment completion (post-treatment). Skeletal muscle (SM) loss was explored as a consequence of energy and protein intake in relation to the minimum and maximum European Society of Parenteral and Enteral Nutrition (ESPEN) guidelines. Higher energy intakes (kcal/kg/day) and increases in energy intake (%) from baseline to post-treatment were correlated with attenuated muscle loss (r = 0.62, p < 0.01; r = 0.47, p = 0.04, respectively). Post-treatment protein intake demonstrated a weak positive correlation (r = 0.44, p = 0.05) with muscle loss, which did not persist when controlling for covariates. Meeting minimum ESPEN energy guidelines (25 kcal/kg/day) did not attenuate SM loss, whereas intakes >30 kcal/kg/day resulted in fewer participants losing muscle. Greater baseline adiposity correlated with greater SM loss (p < 0.001). Energy intakes of 30 kcal/kg/day may be required to protect against SM loss during treatment in HNC patients. The influence of adiposity on SM loss requires further exploration.
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16
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Oyeyemi SO, Braaten T, Skeie G, Borch KB. Competing mortality risks analysis of prediagnostic lifestyle and dietary factors in colorectal cancer survival: the Norwegian Women and Cancer Study. BMJ Open Gastroenterol 2019; 6:e000338. [PMID: 31749978 PMCID: PMC6827763 DOI: 10.1136/bmjgast-2019-000338] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 09/20/2019] [Accepted: 10/03/2019] [Indexed: 12/31/2022] Open
Abstract
Background It remains unclear whether or which prediagnostic lifestyle and dietary factors influence colorectal cancer (CRC) survival following diagnosis. This study used competing mortality risks analysis to evaluate the association between these factors and CRC survival. Methods A total of 96 889 cancer-free participants of the Norwegian Women and Cancer Study completed the study’s baseline questionnaire on lifestyle and dietary factors between 1996 and 2004. Of the 1861 women who subsequently developed CRC, 550 had CRC as the cause of death, while 110 had a non-CRC cause of death. We used multiple imputation to handle missing data. We performed multivariable competing mortality risks analyses to determine the associations between prediagnostic lifestyle and dietary factors and CRC survival. Cause-specific HRs were estimated by Cox regression and subdistribution HRs were estimated by the Fine-Gray regression with corresponding 95% CIs. Results Following multivariable adjustment, a prediagnostic vitamin D intake of >10 μg/day compared with ≤10 μg/day was associated with better CRC survival (HR=0.75, 95% CI 0.61 to 0.92). Other prediagnostic lifestyle and dietary factors showed no association with CRC survival. The corresponding results obtained from cause-specific Cox and Fine-Gray regressions were similar. Conclusion Our study shows that prediagnostic vitamin D intake could improve CRC survival.
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Affiliation(s)
| | - Tonje Braaten
- Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
| | - Guri Skeie
- Community Medicine, UiT The Arctic University of Norway, Tromso, Norway
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Association Between Intake of Red and Processed Meat and Survival in Patients With Colorectal Cancer in a Pooled Analysis. Clin Gastroenterol Hepatol 2019; 17:1561-1570.e3. [PMID: 30476588 PMCID: PMC6533164 DOI: 10.1016/j.cgh.2018.11.036] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Revised: 11/14/2018] [Accepted: 11/16/2018] [Indexed: 02/07/2023]
Abstract
BACKGROUND & AIMS Red and processed meat intake is associated with colorectal cancer (CRC) incidence, but it is not clear if intake is associated with patient survival after diagnosis. METHODS We pooled data from 7627 patients with stage I-IV CRC from 10 studies in the International Survival Analysis in Colorectal Cancer Consortium. Cox proportional hazards regression models were used to evaluate the associations of intake of red and processed meat before diagnosis with overall and CRC-specific survival. RESULTS Among 7627 patients with CRC, 2338 died, including 1576 from CRC, over a median follow-up time of 5.1 years. In multivariable-adjusted analyses, higher intake of red or processed meat was not associated with overall survival of patients with stage I-III CRC: Q4 vs Q1 red meat hazard ratio [HR], 1.08 (95% CI, 0.93-1.26) and Q4 vs Q1 processed meat HR, 1.10 (95% CI, 0.93-1.32) or with CRC-specific survival: Q4 vs Q1 red meat HR, 1.09 (95% CI, 0.89-1.33) and Q4 vs Q1 processed meat HR, 1.11 (95% CI, 0.87-1.42). Results were similar for patients with stage IV CRC. However, patients with stage I-III CRC who reported an intake of processed meat above the study-specific medians had a higher risk of death from any cause (HR, 1.12; 95% CI, 1.01-1.25) than patients who reported eating at or less than the median. CONCLUSION In this large consortium of CRC patient cohorts, intake of red and processed meat before a diagnosis of CRC was not associated with shorter survival time after diagnosis, although a possible weak adverse association cannot be excluded. Studies that evaluate dietary data from several time points before and after cancer diagnosis are required to confirm these findings.
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Cavagnari MAV, Silva TD, Pereira MAH, Sauer LJ, Shigueoka D, Saad SS, Barão K, Ribeiro CCD, Forones NM. Impact of genetic mutations and nutritional status on the survival of patients with colorectal cancer. BMC Cancer 2019; 19:644. [PMID: 31255173 PMCID: PMC6599287 DOI: 10.1186/s12885-019-5837-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 06/17/2019] [Indexed: 12/21/2022] Open
Abstract
Background The prognosis of colorectal cancer (CRC) patients can be influenced by genetic mutations and nutritional status. The relationship between these variables is unclear. The objective of the study was to verify the variables involved in the nutritional status and genetic mutations, which correlate with survival of CRC patients. Methods Patients with surgical intervention for tumor resection were evaluated using body mass index, nutritional screening, patient self-produced global subjective assessment, phase angle, and computed tomography to calculate the areas of visceral adipose tissue (VAT) and subcutaneous adipose tissue, and muscle mass for the determination of sarcopenia. Ten gene mutations involved in CRC carcinogenesis were studied (PIK3CA, KRAS, BRAF, EGFR, NRAS, TP53, APC, PTEN, SMAD4, and FBXW7). DNA was extracted from fresh tumor or paraffin tissues. Results Of the 46 patients, 29 (64.4%) were at nutritional risk and 21 (45.7%) were moderately malnourished. However, there was a high percentage of VAT in 24 (61.5%) and sarcopenia in 19 (48.7%) patients. These variables were associated with a higher risk of mortality. Nutritional risk, moderate or severe malnutrition, phase angle < 5°, VAT < 163.8 cm2 in men and < 80.1 cm2 in women, and sarcopenia were associated with the relative risk of death, with respective hazard ratios/odds ratios and 95% confidence intervals of 8.77 (1.14–67.1), 3.95 (1.11–14.0), 3.79 (1.10–13.1), 3.43 (1.03–11.4), and 3.95 (1.06–14.6). Increased VAT was associated with a lower risk of death, even in patients older than 60 years or those harboring mutated KRAS. Conclusions Patients with positive indicators for malnutrition or risk of malnutrition had an increased risk of death. No relationship was identified between the presence of mutations and survival.
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Affiliation(s)
- Mariana Abe Vicente Cavagnari
- Department of Medicine. Gastroenterology Division. Oncology Group, Universidade Federal de São Paulo - SP. Brazil, R Botucatu 740, 2° andar CEP 04023900, Vila Clementino, São Paulo, Brazil. .,Department of Radiology, Universidade Federal de São Paulo, São Paulo, Brazil.
| | - Tiago Donizetti Silva
- Department of Medicine. Gastroenterology Division. Oncology Group, Universidade Federal de São Paulo - SP. Brazil, R Botucatu 740, 2° andar CEP 04023900, Vila Clementino, São Paulo, Brazil
| | | | - Luísa Jacques Sauer
- Department of Radiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - David Shigueoka
- Department of Radiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Sarhan Sydney Saad
- Department of Surgery, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Katia Barão
- Department of Medicine. Gastroenterology Division. Oncology Group, Universidade Federal de São Paulo - SP. Brazil, R Botucatu 740, 2° andar CEP 04023900, Vila Clementino, São Paulo, Brazil
| | - Carla Caroline Dias Ribeiro
- Department of Medicine. Gastroenterology Division. Oncology Group, Universidade Federal de São Paulo - SP. Brazil, R Botucatu 740, 2° andar CEP 04023900, Vila Clementino, São Paulo, Brazil
| | - Nora Manoukian Forones
- Department of Medicine. Gastroenterology Division. Oncology Group, Universidade Federal de São Paulo - SP. Brazil, R Botucatu 740, 2° andar CEP 04023900, Vila Clementino, São Paulo, Brazil
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Kim S, Ko YH, Song Y, Kang MJ, Lee H, Kim SH, Jeon JY, Cho YU, Yi G, Han J. Development of an exercise adherence program for breast cancer survivors with cancer-related fatigue-an intervention mapping approach. Support Care Cancer 2019; 27:4745-4752. [PMID: 30972643 DOI: 10.1007/s00520-019-04785-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 03/27/2019] [Indexed: 11/29/2022]
Abstract
PURPOSE Cancer-related fatigue (CRF) is the most common and distressing symptom in breast cancer survivors (BCS), with severe impact on quality of life. CRF can be reduced through exercise, but conversely, is also a barrier to exercising. The aim of this article was to apply the intervention mapping protocol (IMP) to develop an exercise adherence intervention for BCS with CRF. METHOD The program was developed using the IMP, which consists of six steps. Based on the data from focus group interviews and literature review, we produced a logic model of change. RESULTS Two performance objectives (survivors adopt and maintain exercise and survivors cope with fatigue) and 17 change objectives were generated. Also, we designed theory-based methods of change, and strategies for practical application. A structured program plan that includes intervention content and methods, ranges, and program data was proposed. Finally, an implementation and evaluation plan was developed. CONCLUSION The IMP provided a useful framework to systematically plan an exercise adherence program. This study resulted in a theory and practice-based exercise adherence program, based on behavioral change theories, and practice-based knowledge that fits the needs of BCS with CRF.
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Affiliation(s)
- Sue Kim
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Yun Hee Ko
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Yoonkyung Song
- Department of Sports Industry Studies, Yonsei University, Seoul, South Korea
| | - Min Jae Kang
- Department of Sports Industry Studies, Yonsei University, Seoul, South Korea
| | - Hyojin Lee
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Sung Hae Kim
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea
| | - Justin Y Jeon
- Department of Sports Industry Studies, Yonsei University, Seoul, South Korea.,Exercise Medicine Center for Diabetes and Cancer Patients, ICONS, Yonsei University, Seoul, South Korea
| | - Young Up Cho
- Division of Breast Surgery, Department of Surgery, Yonsei University College of Medicine, Seoul, South Korea
| | - Gihong Yi
- Department of Sociology, Hallym University, Chuncheon, South Korea
| | - Jeehee Han
- College of Nursing, Yonsei University, 50-1, Yonsei-ro, Seodaemun-gu, Seoul, South Korea.
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Post-cancer diagnosis dietary inflammatory potential is associated with survival among women diagnosed with colorectal cancer in the Women's Health Initiative. Eur J Nutr 2019; 59:965-977. [PMID: 30955051 DOI: 10.1007/s00394-019-01956-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 03/24/2019] [Indexed: 12/21/2022]
Abstract
PURPOSE Dietary factors may influence colorectal cancer (CRC) survival through effects on inflammation. We examined the association between post-CRC diagnosis inflammatory potential of diet and all-cause and cancer-specific mortality in the Women's Health Initiative. METHODS The study included 463 postmenopausal women who developed CRC during follow-up and completed a food frequency questionnaire (FFQ), on average 1.7 years after diagnosis. Women were followed from CRC diagnosis until death, censoring, or the end of follow-up in October 2014. Energy-adjusted dietary inflammatory index (E-DII)® scores were calculated from the FFQ and dietary supplement inventory. Cox proportional hazards models were fitted to estimate multivariable-adjusted HRs and 95% confidence intervals (CIs) for all-cause, total cancer, and CRC-specific mortality with the most pro-inflammatory E-DII scores (tertile 3) as referent. RESULTS After a median 11.6 years of follow-up, 162 deaths occurred, including 77 from CRC. Lowest tertile (i.e., most anti-inflammatory) E-DII scores from diet plus supplements were associated with significantly lower all-cause mortality (HRT1vsT3 = 0.49; 95% CI 0.31-0.79) compared to the most pro-inflammatory E-DII tertile. Modest associations with total cancer mortality or CRC-specific mortality were observed, though 95% CIs included 1. CONCLUSIONS Consuming a dietary pattern and supplements with more anti-inflammatory potential after CRC diagnosis may improve overall survival among postmenopausal women.
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Aubrey V, Hon Y, Shaw C, Burden S. Healthy eating interventions in adults living with and beyond colorectal cancer: a systematic review. J Hum Nutr Diet 2019; 32:501-511. [PMID: 30941834 DOI: 10.1111/jhn.12651] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Rates of cancer survival are increasing, with more people living with and beyond cancer. Lifestyle recommendations for cancer survivors are based largely on extrapolation from cancer prevention recommendations. The present study aimed to systematically review the literature on randomised controlled trials (RCTs) focusing on healthy eating interventions in people with colorectal cancer (CRC). METHODS A structured search of electronic databases was conducted in March 2018 using medical subject headings (MeSH) and text words related to CRC and diet. The results of the literature searches were uploaded to online software for data management. Titles and abstracts were screened based on the inclusion and exclusion criteria and data were extracted. Quality of data was assessed using the Cochrane Handbook. RESULTS Seven studies were identified, including six RCTs and one RCT protocol, with a total of 2233 participants from six studies, of whom 1010 (45%) had CRC. Three studies assessed anthropometrics demonstrating participants who received dietary intervention had a greater reduction in measurements. Six studies assessed changes in dietary components; however, only one demonstrated an increase in dietary fibre. Two studies reported improvements in quality of life favouring dietary intervention groups. CONCLUSIONS The quality of identified studies was variable, with limited evidence to support dietary intervention improving dietary intake in people living with or after CRC. Studies to date have not been based on robust study design that has combined all dietary interventions linked to CRC. As a result of the heterogeneity of the studies identified, it was difficult to draw strong conclusions.
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Affiliation(s)
- V Aubrey
- The Royal Marsden NHS Foundation Trust, London, UK
| | - Y Hon
- The Royal Marsden NHS Foundation Trust, London, UK
| | - C Shaw
- The Royal Marsden NHS Foundation Trust, London, UK.,Biomedical Research Centre at the Royal Marsden and Institute of Cancer Research, London, UK
| | - S Burden
- School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK
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22
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Koh H, Hamada T, Song M, Liu L, Cao Y, Nowak JA, da Silva A, Twombly T, Morikawa T, Kim SA, Masugi Y, Kosumi K, Shi Y, Gu M, Li W, Du C, Chen Y, Li W, Liu H, Li C, Wu K, Nosho K, Inamura K, Hanyuda A, Zhang X, Giannakis M, Chan AT, Fuchs CS, Nishihara R, Meyerhardt JA, Ogino S. Physical Activity and Colorectal Cancer Prognosis According to Tumor-Infiltrating T Cells. JNCI Cancer Spectr 2019; 2:pky058. [PMID: 31276098 PMCID: PMC6591576 DOI: 10.1093/jncics/pky058] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Revised: 09/15/2018] [Accepted: 09/27/2018] [Indexed: 12/11/2022] Open
Abstract
Background Evidence suggests that high-level physical activity may potentially reduce cancer mortality through its immune enhancement effect. We therefore hypothesized that survival benefits associated with physical activity might be stronger in colorectal carcinomas with lower immune reaction at diagnosis. Methods Using molecular pathological epidemiology databases of 470 colon and rectal carcinoma cases in the Nurses’ Health Study and the Health Professionals Follow-up Study, we assessed the prognostic association of postdiagnosis physical activity in strata of densities of CD3+ cells, CD8+ cells, CD45RO (PTPRC)+ cells, or FOXP3+ cells in tumor tissue. Cox proportional hazards regression model was used to adjust for potential confounders, including microsatellite instability, CpG island methylator phenotype, long interspersed nucleotide element-1 methylation, KRAS, BRAF, and PIK3CA mutations, and expression of CTNNB1 (beta-catenin), PTGS2 (cyclooxygenase-2), and IRS1. Results The association of postdiagnosis physical activity with colorectal cancer-specific mortality differed by CD3+ cell density (Pinteraction < .001). Multivariable-adjusted colorectal cancer-specific mortality hazard ratios for a quartile-unit increase in physical activity were 0.56 (95% confidence interval = 0.38 to 0.83) among cases with the lowest quartile of CD3+ cell density compared with 1.14 (95% confidence interval = 0.79 to 1.65) in cases with the highest quartile. We observed no differential survival association of physical activity by densities of CD8+ cells, CD45RO+ cells, or FOXP3+ cells. Conclusions The association between postdiagnosis physical activity and colorectal cancer survival appeared stronger for carcinomas with lower T cell infiltrates, suggesting an interactive effect of exercise and immunity on colorectal cancer progression.
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Affiliation(s)
- Hideo Koh
- Department of Oncologic Pathology.,Department of Hematology, Graduate School of Medicine, Osaka City University, Osaka, Japan
| | | | - Mingyang Song
- Department of Nutrition.,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA.,Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Li Liu
- Department of Oncologic Pathology.,Department of Nutrition.,Department of Epidemiology and Biostatistics, and the Ministry of Education Key Lab of Environment and Health, School of Public Health, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Yin Cao
- Division of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, MO
| | - Jonathan A Nowak
- Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | | | | | - Teppei Morikawa
- Department of Pathology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sun A Kim
- Laboratory of Human Carcinogenesis, National Cancer Institute, National Institutes of Health, Bethesda, MD
| | | | | | - Yan Shi
- Department of Oncologic Pathology.,Department of Medical Oncology, Chinese PLA General Hospital, Beijing, P.R. China
| | - Mancang Gu
- Department of Oncologic Pathology.,College of Pharmacy, Zhejiang Chinese Medical University, Zhejiang, P.R. China
| | | | | | | | | | | | | | - Kana Wu
- Department of Nutrition.,Department of Epidemiology.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Katsuhiko Nosho
- Department of Gastroenterology, Rheumatology, and Clinical Immunology, Sapporo Medical University School of Medicine, Sapporo, Japan
| | - Kentaro Inamura
- Division of Pathology, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan
| | - Akiko Hanyuda
- Department of Nutrition.,Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
| | - Xuehong Zhang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Marios Giannakis
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.,Broad Institute of MIT and Harvard, Cambridge, MA.,Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Andrew T Chan
- Department of Immunology and Infectious Diseases.,Clinical and Translational Epidemiology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA.,Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.,Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Broad Institute of MIT and Harvard, Cambridge, MA
| | - Charles S Fuchs
- Yale Cancer Center, New Haven, CT.,Department of Medicine, Yale School of Medicine, New Haven, CT.,Smilow Cancer Hospital, New Haven, CT
| | - Reiko Nishihara
- Department of Oncologic Pathology.,Department of Nutrition.,Department of Epidemiology.,Department of Immunology and Infectious Diseases.,Department of Biostatistics, Harvard TH Chan School of Public Health, Boston, MA.,Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Jeffrey A Meyerhardt
- Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA
| | - Shuji Ogino
- Department of Oncologic Pathology.,Department of Epidemiology.,Program in MPE Molecular Pathological Epidemiology, Department of Pathology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA.,Broad Institute of MIT and Harvard, Cambridge, MA
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23
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Agyemang-Yeboah F, Yorke J, Obirikorang C, Nsenbah Batu E, Acheampong E, Amankwaa Frimpong E, Odame Anto E, Amankwaa B. Colorectal cancer survival rates in Ghana: A retrospective hospital-based study. PLoS One 2018; 13:e0209307. [PMID: 30566456 PMCID: PMC6300283 DOI: 10.1371/journal.pone.0209307] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2017] [Accepted: 12/04/2018] [Indexed: 12/24/2022] Open
Abstract
Background Colorectal cancer (CRC) is one of the commonest cancers associated with diverse prognosis times in different parts of the world. Despite medical interventions, the overall clinical outcomes and survival remains very poor for most patients in developing countries. This study therefore investigated the survival rate of colorectal cancer and its prognostic factors among patients at Komfo Anokye Teaching Hospital, Ghana. Methodology In this retrospective cohort study, a total of 221 patients diagnosed with CRC from 2009 to 2015 at the Surgical and Oncological units of Komfo Anokye Teaching Hospital (KATH), Kumasi, Ghana were employed. The survival graphs were obtained using the Kaplan–Meier method and compared by the Log-rank test. Cox regression analysis was used to assess prognostic factors. All analyses were performed by SPSS version 22. Results The median survival time was 15 months 95% CI (11.79–18.21). The overall survival rate for CRC over the 5 years period was 16.0%. The survival rates at the 1st, 2nd, 3rd, 4th and 5th years were 64% 95% CI (56.2–71.1), 40% 95% CI (32.2–50.1), 21% 95% CI (11.4–30.6) 16% 95% CI (8.9–26.9) and 16% 95% CI (7.3–24.9). There was a significant difference in the survival rate of colorectal cancer according to the different stages (p = 0.0001). Family history [HR = (3.44), p = 0.029)], Chemotherapy [HR = (0.23), p = <0.0001)], BMI [HR = (1.78), p = 0.017)] and both chemo/radiotherapy (HR = (3.63), p = 0.042)] were the significant social and clinical factors influencing the overall survival. Pathological factors such as TNM tumour stage (p = 0.012), depth of tumour invasion (p = 0.036), lymph node metastasis (p = 0.0001), and distance metastasis (p = 0.001) were significantly associated with overall survival. Conclusion The study has clearly demonstrated that survival rate for CRC patients at KATH, Ghana is very low in a 5 years period. This is influenced by significant number of clinical and pathological prognostic factors. Identification of prognostic factors would be a primary basis for early prediction and treatment of patients with colorectal cancer.
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Affiliation(s)
- Francis Agyemang-Yeboah
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Joseph Yorke
- Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi, Ghana
| | - Christian Obirikorang
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Emmanuella Nsenbah Batu
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
| | - Emmanuel Acheampong
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
- * E-mail:
| | | | - Enoch Odame Anto
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, Western Australia, Australia
| | - Bright Amankwaa
- Department of Molecular Medicine, School of Medical Science, Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana
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24
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Mizota Y, Kanemitsu Y, Tsukamoto S, Shida D, Ochiai H, Yamamoto S. ROK study-C (Rainbow of KIBOU study-colorectum): a colorectal cancer survivor cohort study on food, nutrition, physical activity, psychosocial factors and its influences on colorectal cancer recurrence, survival and quality of life in Japan. BMC Cancer 2018; 18:953. [PMID: 30286723 PMCID: PMC6172783 DOI: 10.1186/s12885-018-4830-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 09/18/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Many studies have shown that lifestyle factors such as diet, physical activity are related to the incidence of cancer. However, there are few studies on the association between lifestyle factors and cancer prognosis. To investigate the influence of lifestyle factors and psychosocial factors on prognosis, we started a prospective study of women with breast cancer, the Rainbow of KIBOU study-Breast (ROK Study-B) in 2007. As of February 2018, more than 6300 women have been enrolled, thus making this one of the world's largest cancer patient cohort studies. Based on the know-how obtained from this study, we started another new cohort study for colorectal cancer patient (ROK Study-C). METHODS The ROK Study-C is a prospective observational study for colorectal cancer survivors at the National Cancer Center Hospital. Participants fill in several self-administrated questionnaires about lifestyle, psychosocial factors (including posttraumatic growth and benefit finding, support), and quality of life (QOL) 5 times in total: at diagnosis, 3 and 6 months, 1 and 5 years after surgery. CT-scans will be collected to assess body composition and obesity. We also use blood and cancer tissue from the Biobank. The primary endpoint is disease-free survival. The secondary endpoints are overall survival and health-related QOL. The planned sample size is 2000 and the follow-up period is 5 years after the last enrollment. DISCUSSION Recruitment began in December 2015 and the study is still ongoing. The ROK Study-C will contribute to improvements in patient prognosis and yield important evidence for colorectal cancer survivorship.
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Affiliation(s)
- Yuri Mizota
- Division of Health Sociology, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo, Tokyo, 104-0045 Japan
| | - Yukihide Kanemitsu
- Department of Colorectal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo, Tokyo, 104-0045 Japan
| | - Shunsuke Tsukamoto
- Department of Colorectal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo, Tokyo, 104-0045 Japan
| | - Dai Shida
- Department of Colorectal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo, Tokyo, 104-0045 Japan
| | - Hiroki Ochiai
- Department of Colorectal Surgery, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo, Tokyo, 104-0045 Japan
| | - Seiichiro Yamamoto
- Division of Health Sociology, Center for Public Health Sciences, National Cancer Center, 5-1-1 Tsukiji, Chuo, Tokyo, 104-0045 Japan
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25
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Soares-Miranda L, Abreu S, Ruiz-Casado A, Lucia A. Physical activity and nutritional interventions and health-related quality of life in colorectal cancer survivors: a review. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23809000.2018.1503538] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Luisa Soares-Miranda
- University of Porto, Research Center in Physical Activity Health and Leisure, Faculty of Sport, Porto, Portugal
| | - Sandra Abreu
- University of Porto, Research Center in Physical Activity Health and Leisure, Faculty of Sport, Porto, Portugal
- Faculty of Psychology, Education and Sport, Lusófona University of Porto, Porto, Portugal
| | - Ana Ruiz-Casado
- Department of Medical Oncology, Hospital Universitario Puerta de Hierro, Madrid, Spain
| | - Alejandro Lucia
- Research Institute of Hospital 12 de Octubre (‘i+12ʹ), Madrid, Spain
- Faculty of Sport Sciences, Universidad Europea de Madrid, Madrid, Spain
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26
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Glenn BA, Hamilton AS, Nonzee NJ, Maxwell AE, Crespi CM, Ryerson AB, Chang LC, Deapen D, Bastani R. Obesity, physical activity, and dietary behaviors in an ethnically-diverse sample of cancer survivors with early onset disease. J Psychosoc Oncol 2018; 36:418-436. [PMID: 29764334 PMCID: PMC6209096 DOI: 10.1080/07347332.2018.1448031] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE To assess weight status, physical activity, and dietary behaviors in an ethnically-diverse sample of breast and colorectal cancer survivors with early onset disease (≤ 50 years). METHODS Breast and colorectal cancer survivors, diagnosed between 1999 and 2009 with early-stage cancer diagnosed by 50 years of age, were identified through a population-based cancer registry and surveyed. Descriptive and regression analyses were conducted to characterize the sample and identify correlates of lifestyle behaviors. FINDINGS The majority of participants (n = 156) were female (83%), insured (84%), and racial/ethnic minorities (29% Asian, 24% Latino, 15% African American). Participants' mean age at response was 50 years and mean time since diagnosis was 9 years. Over half of survivors were overweight or obese. Few participants reported engaging in regular physical activity (31%) and adhering to minimum guidelines for fruit and vegetable consumption (32%). A substantial proportion of survivors consumed fast food in the past week (75%) and nearly half (48%) reported daily consumption of sugar-sweetened beverages. Lower income was associated with inadequate fruit and vegetable intake. Fast food and sugar-sweetened beverage consumption was significantly higher among racial/ethnic minority survivors compared to non-Latino whites. CONCLUSIONS High prevalence of overweight and suboptimal adherence to recommended nutrition and physical activity behaviors were observed among cancer survivors with early onset disease. Cancer survivors diagnosed at a young age may benefit from targeted interventions to address overweight and suboptimal nutrition and physical activity.
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Affiliation(s)
- Beth A Glenn
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - Ann S Hamilton
- b Department of Preventive Medicine, Los Angeles County Cancer Surveillance Program and Keck School of Medicine , University of Southern California , Los Angeles , California , USA
| | - Narissa J Nonzee
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - Annette E Maxwell
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - Catherine M Crespi
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - A Blythe Ryerson
- c Division of Cancer Prevention and Control, Centers for Disease Control and Prevention , Atlanta , Georgia , USA
| | - L Cindy Chang
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
| | - Dennis Deapen
- b Department of Preventive Medicine, Los Angeles County Cancer Surveillance Program and Keck School of Medicine , University of Southern California , Los Angeles , California , USA
| | - Roshan Bastani
- a Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Fielding School of Public Health and Jonsson Comprehensive Cancer Center , University of California , Los Angeles , California , USA
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27
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Zhang Z, Bu X, Yang J, Zhu S, He S, Zheng J, Wang W, Chu D. NOTCH4 regulates colorectal cancer proliferation, invasiveness, and determines clinical outcome of patients. J Cell Physiol 2018; 233:6975-6985. [PMID: 29693251 DOI: 10.1002/jcp.26619] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2017] [Accepted: 03/28/2018] [Indexed: 12/31/2022]
Abstract
Notch signal has complex roles in human malignancies, which might be attributed to the diversity of Notch receptors. Here, we set out to identify the association of NOTCH4 with colorectal cancer (CRC). In the hospital-based study cohort, we investigated NOTCH4 mRNA levels in primary CRC, as well as its association with clinicopathologic characteristics. Besides, NOTCH4 cDNA and siRNA was transfected into colorectal cancer cell line to elucidate its impact on tumor cell proliferation and migration. Results revealed a statistically significant lower expression of NOTCH4 mRNA in tumor specimens compared with that in control. NOTCH4 level in CRC was found to be related to tumor differentiation, invasion, and node metastasis. Moreover, it was demonstrated that NOTCH4 mRNA level could be an independent prognostic factor for both disease-free and overall survival of CRC patients. Overexpression of NOTCH4 in CRC cell lines suppressed tumor cell proliferation, migration, and invasion, while induced apoptosis. In the opposite, the malignant behavior of CRC cells was enhanced by NOTCH4 knockdown. These results demonstrated for the first time that NOTCH4 expression was decreased in CRC, which could determine tumor proliferation, relapse, and prognosis.
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Affiliation(s)
- Zixi Zhang
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.,Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Xin Bu
- State Key Laboratory of Cancer Biology and Department of Biochemistry and Molecular Biology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jingyi Yang
- Information Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shaojun Zhu
- Department of Pathology, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shuixiang He
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jianyong Zheng
- Department of Gastrointestinal Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi'an, China
| | - Weizhong Wang
- Department of Gastrointestinal Surgery, Xijing Hospital of Digestive Diseases, The Fourth Military Medical University, Xi'an, China
| | - Dake Chu
- Department of Gastroenterology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
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28
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Jayasekara H, English DR, Haydon A, Hodge AM, Lynch BM, Rosty C, Williamson EJ, Clendenning M, Southey MC, Jenkins MA, Room R, Hopper JL, Milne RL, Buchanan DD, Giles GG, MacInnis RJ. Associations of alcohol intake, smoking, physical activity and obesity with survival following colorectal cancer diagnosis by stage, anatomic site and tumor molecular subtype. Int J Cancer 2017; 142:238-250. [PMID: 28921583 DOI: 10.1002/ijc.31049] [Citation(s) in RCA: 68] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2017] [Revised: 08/13/2017] [Accepted: 09/01/2017] [Indexed: 01/11/2023]
Abstract
The influence of lifestyle factors on survival following a diagnosis of colorectal cancer (CRC) is not well established. We examined associations between lifestyle factors measured before diagnosis and CRC survival. The Melbourne Collaborative Cohort Study collected data on alcohol intake, cigarette smoking and physical activity, and body measurements at baseline (1990-1994) and wave 2 (2003-2007). We included participants diagnosed to 31 August 2015 with incident stages I-III CRC within 10-years post exposure assessment. Information on tumor characteristics and vital status was obtained. Tumor DNA was tested for microsatellite instability (MSI) and somatic mutations in oncogenes BRAF (V600E) and KRAS. We estimated hazard ratios (HRs) for associations between lifestyle factors and overall and CRC-specific mortality using Cox regression. Of 724 eligible CRC cases, 339 died (170 from CRC) during follow-up (average 9.0 years). Exercise (non-occupational/leisure-time) was associated with higher CRC-specific survival for stage II (HR = 0.25, 95% CI: 0.10-0.60) but not stages I/III disease (p for interaction = 0.01), and possibly for colon and KRAS wild-type tumors. Waist circumference was inversely associated with CRC-specific survival (HR = 1.25 per 10 cm increment, 95% CI: 1.08-1.44), independent of stage, anatomic site and tumor molecular status. Cigarette smoking was associated with lower overall survival, with suggestive evidence of worse survival for BRAF mutated CRC, but not with CRC-specific survival. Alcohol intake was not associated with survival. Survival did not differ by MSI status. We have identified pre-diagnostic predictors of survival following CRC that may have clinical and public health relevance.
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Affiliation(s)
- Harindra Jayasekara
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Vic, Australia.,Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Melbourne, Vic, Australia.,Centre for Alcohol Policy Research, La Trobe University, 215 Franklin Street, Melbourne, Vic, Australia
| | - Dallas R English
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Vic, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic, Australia
| | - Andrew Haydon
- Department of Medical Oncology, Alfred Hospital, 55 Commercial Road, Melbourne, Vic, Australia
| | - Allison M Hodge
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Vic, Australia
| | - Brigid M Lynch
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Vic, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic, Australia.,Physical Activity Laboratory, Baker IDI Heart and Diabetes Institute, 75 Commercial Road, Melbourne, Vic, Australia
| | - Christophe Rosty
- Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Melbourne, Vic, Australia.,Envoi Specialist Pathologists, Brisbane, QLD, Australia.,School of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Elizabeth J Williamson
- Farr Institute of Health Informatics Research, London, United Kingdom.,Department of Medical Statistics, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Mark Clendenning
- Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Melbourne, Vic, Australia
| | - Melissa C Southey
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Melbourne, Vic, Australia
| | - Mark A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic, Australia
| | - Robin Room
- Centre for Alcohol Policy Research, La Trobe University, 215 Franklin Street, Melbourne, Vic, Australia.,Centre for Health Equity, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic, Australia.,Centre for Social Research on Alcohol and Drugs, Stockholm University, Stockholm, SE, Sweden
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic, Australia
| | - Roger L Milne
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Vic, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic, Australia
| | - Daniel D Buchanan
- Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Melbourne, Vic, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic, Australia.,Genetic Medicine and Family Cancer Clinic, Royal Melbourne Hospital, Melbourne, Vic, Australia
| | - Graham G Giles
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Vic, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic, Australia
| | - Robert J MacInnis
- Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, 615 St Kilda Road, Melbourne, Vic, Australia.,Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, 207 Bouverie Street, Melbourne, Vic, Australia
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29
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Alexander D, Allardice GM, Moug SJ, Morrison DS. A retrospective cohort study of the influence of lifestyle factors on the survival of patients undergoing surgery for colorectal cancer. Colorectal Dis 2017; 19:544-550. [PMID: 28027419 DOI: 10.1111/codi.13594] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2016] [Accepted: 09/27/2016] [Indexed: 02/08/2023]
Abstract
AIM Several modifiable and nonmodifiable health-related behaviours are associated with the incidence of colorectal cancer (CRC), but there is little research on their association with survival. This work aimed to investigate possible relationships between modifiable behavioural factors and outcomes on a study cohort of CRC patients undergoing potentially curative surgery. METHOD A retrospective cohort study was carried out of patients diagnosed with nonmetastatic CRC residing in the NHS Greater Glasgow and Clyde area, UK and undergoing elective curative surgery (January 2011 to December 2012). Data were obtained from the Scottish Cancer Registry, National Scottish Death Records. Preoperative assessment of smoking, alcohol consumption, nurse-measured body mass index (BMI) and exercise levels were recorded, and patients were followed until death or censorship. Survival analysis was carried out and proportional hazards assumptions were assessed graphically using plots and were then formally tested using the PHTEST procedure in stata. RESULT Of the initial 527 patients, 181 (34%) satisfied the inclusion criteria. The total duration of follow-up was 480 person-years. At the preoperative assessment, 75% of patients were overweight or obese, 10.6% were current smokers, 13.1% recorded excess alcohol consumption and 8.5% had physical difficulty climbing stairs. Age, BMI, histopathological stage and physical capacity all independently affected survival (P < 0.05). Overweight patients [hazard ratio (HR) 2.81] and those who had difficulty climbing stairs (HR 3.31) had a significantly poorer survival. CONCLUSION This study found evidence that preoperative exercise capacity and BMI are important independent prognostic factors of survival in patients undergoing curative surgery for CRC.
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Affiliation(s)
| | - G M Allardice
- West of Scotland Cancer Surveillance Unit, University of Glasgow, Glasgow, UK
| | - S J Moug
- Department of Surgery, Royal Alexandra Hospital, Paisley, UK
| | - D S Morrison
- West of Scotland Cancer Surveillance Unit, University of Glasgow, Glasgow, UK
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Is Type D personality a risk factor for all-cause mortality? A prospective population-based study among 2625 colorectal cancer survivors from the PROFILES registry. J Psychosom Res 2017; 96:76-83. [PMID: 28545796 DOI: 10.1016/j.jpsychores.2017.03.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 03/09/2017] [Accepted: 03/10/2017] [Indexed: 11/20/2022]
Abstract
UNLABELLED Objective Our goal was to examine whether Type D personality and its components, negative affectivity (NA) and social inhibition (SI), were associated with all-cause mortality among colorectal cancer (CRC) patients. METHODS CRC patients diagnosed between 2000 and 2009, as registered in the Dutch population-based Eindhoven Cancer Registry, received a questionnaire on Type D (DS14) on average 5.3years after diagnosis. Survival status (31-12-2013) was obtained from the Central Bureau for Genealogy. We used a Cox proportional hazard model to relate personality to all-cause mortality, while adjusting for demographics, clinical characteristics and cardiovascular disease (CVD). RESULTS Fifty percent was categorized as the 'reference group' (n=1281), 17% as 'SI only' (n=421), 12% as 'NA only' (n=309), and 21% as 'Type D' (n=532). After adjustment, CRC patients in the 'NA only' and 'Type D' groups showed an increased risk (HR=2.0, 95% CI=1.4-2.8, p<0.01, and HR=1.7, 95% CI=1.3-2.4, p<0.01) for all-cause mortality. This adverse effect of NA was limited to men aged >70. There was an additional adverse effect of SI on all-cause mortality in older men without CVD (HR=2.3, 95% CI=1.2-4.4, p=0.01). Personality was not related to mortality in women. Entering personality continuously, showed an increased risk for NA among older survivors, men and patients with comorbid CVD. Neither SI nor the interaction term was predictive in both the un- and adjusted Cox models. CONCLUSION Our findings suggest that it is the NA component that drives the adverse effect of psychological distress on survival in CRC patients, which is most prominent among older men.
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31
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The future of food colloids: Next-generation nanoparticle delivery systems. Curr Opin Colloid Interface Sci 2017. [DOI: 10.1016/j.cocis.2016.12.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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Jackson SE, Heinrich M, Beeken RJ, Wardle J. Weight Loss and Mortality in Overweight and Obese Cancer Survivors: A Systematic Review. PLoS One 2017; 12:e0169173. [PMID: 28060948 PMCID: PMC5218508 DOI: 10.1371/journal.pone.0169173] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Accepted: 12/13/2016] [Indexed: 12/17/2022] Open
Abstract
Background Excess adiposity is a risk factor for poorer cancer survival, but there is uncertainty over whether losing weight reduces the risk. We conducted a critical review of the literature examining weight loss and mortality in overweight or obese cancer survivors. Methods We systematically searched PubMed and EMBASE for articles reporting associations between weight loss and mortality (cancer-specific or all-cause) in overweight/obese patients with obesity-related cancers. Where available, data from the same studies on non-overweight patients were compared. Results Five articles describing observational studies in breast cancer survivors were included. Four studies reported a positive association between weight loss and mortality in overweight/obese survivors, and the remaining study observed no significant association. Results were similar for non-overweight survivors. Quality assessment indicated high risk of bias across studies. Conclusions There is currently a lack of observational evidence that weight loss improves survival for overweight and obese cancer survivors. However, the potential for bias in these studies is considerable and the results likely reflect the consequences of disease-related rather than intentional weight loss. There is a need for stronger study designs, incorporating measures of intentionality of weight loss, and extended to other cancers.
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Affiliation(s)
- Sarah E. Jackson
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
- * E-mail:
| | - Malgorzata Heinrich
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
| | - Rebecca J. Beeken
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
| | - Jane Wardle
- Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, United Kingdom
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Xiao J, Mazurak VC, Olobatuyi TA, Caan BJ, Prado CM. Visceral adiposity and cancer survival: a review of imaging studies. Eur J Cancer Care (Engl) 2016; 27:e12611. [PMID: 27921375 DOI: 10.1111/ecc.12611] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/28/2016] [Indexed: 02/06/2023]
Abstract
Although obesity is a well-known risk factor for cancer, the association between obesity and cancer survival remains controversial. This is partially due to the inability of conventional obesity measures to directly assess adiposity or adipose tissue distribution. As a metabolic organ, visceral adipose tissue (VAT) secrets a variety of cytokines and cytokine-like factors, potentially affecting cancer survival. The objective of this review was to investigate the influence of imaging-assessed VAT on cancer survival. A total of 22 studies assessing the impact of visceral adiposity on survival were included. Negative associations between VAT and survival were more frequently observed among patients with colorectal (four of six studies) and pancreatic (three of five studies) cancers, compared to higher VAT predicting longer survival in most studies of renal cell carcinoma patients (four of five studies). Methodological limitations, including unstandardised VAT measurement methods, lack of other body composition measurement (i.e. muscle mass), small sample size and heterogeneous cohort characteristics, may explain controversial findings related to the impact of VAT on cancer survival.
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Affiliation(s)
- J Xiao
- Department of Agricultural, Food and Nutritional Science, Division of Human Nutrition, 4-002 Li Ka Shing Centre, University of Alberta, Edmonton, AB, Canada
| | - V C Mazurak
- Department of Agricultural, Food and Nutritional Science, Division of Human Nutrition, 4-002 Li Ka Shing Centre, University of Alberta, Edmonton, AB, Canada
| | - T A Olobatuyi
- Department of Agricultural, Food and Nutritional Science, Division of Human Nutrition, 4-002 Li Ka Shing Centre, University of Alberta, Edmonton, AB, Canada
| | - B J Caan
- Division of Research, Kaiser Permanente, Oakland, CA, USA
| | - C M Prado
- Department of Agricultural, Food and Nutritional Science, Division of Human Nutrition, 4-002 Li Ka Shing Centre, University of Alberta, Edmonton, AB, Canada
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Wang N, Khankari NK, Cai H, Li HL, Yang G, Gao YT, Xiang YB, Shu XO, Zheng W. Prediagnosis body mass index and waist-hip circumference ratio in association with colorectal cancer survival. Int J Cancer 2016; 140:292-301. [PMID: 27706816 DOI: 10.1002/ijc.30459] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Revised: 09/01/2016] [Accepted: 09/26/2016] [Indexed: 01/03/2023]
Abstract
The association of obesity on survival among patients with colorectal cancer (CRC) has not been well characterized. We investigated the association of prediagnostic body mass index (BMI)/waist-hip ratio (WHR) and total/cause-specific mortality in CRC patients. Our study included 1,452 patients who participated in two large cohort studies and were diagnosed with CRC during follow-up period. Participants were measured for anthropometrics and interviewed to collect relevant information at baseline, prior to any cancer diagnosis. Data on site-specific cancer incidence and cause-specific mortality were obtained via in-person surveys and annual record linkage with cancer and vital statistics registries. Cox proportional hazard models were used to evaluate the associations of BMI and WHR with survival. A total of 547 participants died during the follow-up period, including 499 who died of CRC. Relative to normal BMI (18.5 to <25.0 kg/m2 ), obesity (BMI ≥ 30 kg/m2 ) was associated with increased mortality resulting from all causes [hazard ratio (HR) = 1.5, 95% confidence interval (CI): 1.1-2.1] and CRC (HR = 1.5, 95% CI: 1.1-2.1). Elevated risk of death was also found among underweight patients (BMI < 18.5 kg/m2 ), although not all risk estimates were statistically significant. Overweight BMI (25.0 to <30.0 kg/m2 ) was not associated with risk of death among CRC patients, nor was WHR. In conclusion, prediagnostic BMI was associated with survival among CRC patients following a U-shape pattern; obesity was associated with high mortality after CRC diagnosis. These findings provide support for maintaining healthy weight to improve the survival of CRC patients.
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Affiliation(s)
- Nan Wang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN.,Department of General Surgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, People's Republic of China
| | - Nikhil K Khankari
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Hong-Lan Li
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Gong Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Yong-Bing Xiang
- Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
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Husson O, Denollet J, Ezendam NPM, Mols F. Personality, health behaviors, and quality of life among colorectal cancer survivors: Results from the PROFILES registry. J Psychosoc Oncol 2016; 35:61-76. [DOI: 10.1080/07347332.2016.1226227] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Olga Husson
- Department of Medical Psychology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Johan Denollet
- Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
| | - Nicole P. M. Ezendam
- Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands, Eindhoven Cancer Registry, Eindhoven, The Netherlands
| | - Floortje Mols
- Department of Medical and Clinical Psychology, CoRPS-Center of Research on Psychology in Somatic Diseases, Tilburg University, Tilburg, The Netherlands
- Comprehensive Cancer Centre the Netherlands, Eindhoven Cancer Registry, Eindhoven, The Netherlands
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36
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Gavrilas LI, Ionescu C, Tudoran O, Lisencu C, Balacescu O, Miere D. The Role of Bioactive Dietary Components in Modulating miRNA Expression in Colorectal Cancer. Nutrients 2016; 8:nu8100590. [PMID: 27681738 PMCID: PMC5083978 DOI: 10.3390/nu8100590] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 08/31/2016] [Accepted: 09/18/2016] [Indexed: 02/07/2023] Open
Abstract
Colorectal cancer is the third most common cancer in the world and considered to be one of the most diet-related types of cancer. Extensive research has been conducted but still the link between diet and colorectal cancer is complex. Recent studies have highlight microRNAs (miRNAs) as key players in cancer-related pathways in the context of dietary modulation. MicroRNAs are involved in most biological processes related to tumor development and progression; therefore, it is of great interest to understand the underlying mechanisms by which dietary patterns and components influence the expression of these powerful molecules in colorectal cancer. In this review, we discuss relevant dietary patterns in terms of miRNAs modulation in colorectal cancer, as well as bioactive dietary components able to modify gene expression through changes in miRNA expression. Furthermore, we emphasize on protective components such as resveratrol, curcumin, quercetin, α-mangostin, omega-3 fatty acids, vitamin D and dietary fiber, with a focus on the molecular mechanisms in the context of prevention and even treatment. In addition, several bioactive dietary components that have the ability to re-sensitize treatment resistant cells are described.
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Affiliation(s)
- Laura I Gavrilas
- Department of Bromatology, Hygiene, Nutrition, University of Medicine and Pharmacy "Iuliu Hatieganu", Marinescu Street 23, Cluj-Napoca 400337, Romania.
| | - Corina Ionescu
- Department of Pharmaceutical Biochemistry and Clinical Laboratory, University of Medicine and Pharmacy "Iuliu Hatieganu", Louis Pasteur Street 6, Cluj-Napoca 400349, Romania.
| | - Oana Tudoran
- Department of Functional Genomics, Proteomics and Experimental Pathology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Republicii Street 34-36, Cluj-Napoca 400015, Romania.
| | - Cosmin Lisencu
- Department of Surgical and Gynecological Oncology, University of Medicine and Pharmacy "Iuliu Hatieganu", Republicii Street 34-36, Cluj-Napoca 400015, Romania.
- Department of Surgery, The Oncology Institute "Prof. Dr. Ion Chiricuta", Republicii Street 34-36, Cluj-Napoca 400015, Romania.
| | - Ovidiu Balacescu
- Department of Functional Genomics, Proteomics and Experimental Pathology, The Oncology Institute "Prof. Dr. Ion Chiricuta", Republicii Street 34-36, Cluj-Napoca 400015, Romania.
| | - Doina Miere
- Department of Bromatology, Hygiene, Nutrition, University of Medicine and Pharmacy "Iuliu Hatieganu", Marinescu Street 23, Cluj-Napoca 400337, Romania.
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Massalou D, Benizri E, Chevallier A, Duranton-Tanneur V, Pedeutour F, Benchimol D, Béréder JM. Peritoneal carcinomatosis of colorectal cancer: novel clinical and molecular outcomes. Am J Surg 2016; 213:377-387. [PMID: 27816197 DOI: 10.1016/j.amjsurg.2016.03.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Revised: 03/17/2016] [Accepted: 03/29/2016] [Indexed: 12/16/2022]
Abstract
BACKGROUND The objective of this study was to identify the prognostic impact of parameters in peritoneal carcinomatosis from colorectal cancer. METHODS We collected data from patients treated by cytoreductive surgery and Hyperthermic Intraperitoneal Chemotherapy for peritoneal carcinomatosis secondary to colorectal cancer. RESULTS Ninety-one procedures were performed. In univariate analysis, an increased peritoneal cancer index was associated with decreased survival (P < .001). The presence of signet ring cells was associated to a decrease in survival from 45.8 to 12.1 months (P < .001). Microsatellite sequences instability status was the only molecular prognostic factor correlated with an increase in median disease-free survival: 12.4 vs 24.9 months (P = .01). The presence of a mucinous component was associated with a decreased of survival from 51.9 to 35.1 months (P = .02). CONCLUSIONS Clinical factors were affecting the survival of patients. The absence of signet ring cells and mucinous component and the presence of microsatellite sequences instability may be favorable prognostic factors.
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Affiliation(s)
- Damien Massalou
- Department of General Surgery and Digestive Cancerology, Nice University Hospital, 151 route de St. Antoine de Ginestière, Nice, 06200, France; Acute Care Surgery Unit, Emergency Department and Intensive Care, Nice University Hospital, University of Nice Sophia-Antipolis, Nice, France
| | - Emmanuel Benizri
- Department of General Surgery and Digestive Cancerology, Nice University Hospital, 151 route de St. Antoine de Ginestière, Nice, 06200, France.
| | - Anne Chevallier
- Central Laboratory of Pathology, Laboratory Department, Nice University Hospital, University of Nice Sophia-Antipolis, Nice, France
| | - Valérie Duranton-Tanneur
- Laboratory of Solid Tumor Genetics, Laboratory Department, Nice University Hospital, University of Nice Sophia-Antipolis, Nice, France
| | - Florence Pedeutour
- Laboratory of Solid Tumor Genetics, Laboratory Department, Nice University Hospital, University of Nice Sophia-Antipolis, Nice, France
| | - Daniel Benchimol
- Department of General Surgery and Digestive Cancerology, Nice University Hospital, 151 route de St. Antoine de Ginestière, Nice, 06200, France
| | - Jean-Marc Béréder
- Department of General Surgery and Digestive Cancerology, Nice University Hospital, 151 route de St. Antoine de Ginestière, Nice, 06200, France
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Winkels RM, van Lee L, Beijer S, Bours MJ, van Duijnhoven FJB, Geelen A, Hoedjes M, Mols F, de Vries J, Weijenberg MP, Kampman E. Adherence to the World Cancer Research Fund/American Institute for Cancer Research lifestyle recommendations in colorectal cancer survivors: results of the PROFILES registry. Cancer Med 2016; 5:2587-95. [PMID: 27418442 PMCID: PMC5055169 DOI: 10.1002/cam4.791] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Revised: 04/12/2016] [Accepted: 05/13/2016] [Indexed: 12/31/2022] Open
Abstract
We examined adherence to the eight The World Cancer Research Foundation/American Institute for Cancer Research (WCRF/AICR) recommendations on diet, physical activity, and body weight among colorectal cancer survivors, and whether adherence was associated with intention to eat healthy and with the need for dietary advice. Adherence to these recommendations may putatively reduce the risk of recurrence and death. Studies on adherence to these recommendations in colorectal cancer (CRC) survivors are lacking. Adherence was assessed in a cross-sectional study among 1196 CRC survivors and could range between 0 (no adherence) and 8 points (complete adherence). Participants completed questionnaires on dietary intake, physical activity, and body weight. Prevalence Ratios were calculated to assess whether adherence to recommendations were associated with dietary intentions and needs. Twelve percentage of the survivors adhered to 6 or more recommendations; 65% had a score between >4 and 6 points; 23% scored no more than 4 points. The recommendation for to be modest with consumption of meat showed lowest adherence: 8% adhered; whereas the recommendation not to use dietary supplements showed highest adherence (75%). 18% reported a need for dietary advice, but this was not associated with adherence to recommendations. Survivors with higher adherence reported less often that they had received dietary advice, were less likely to have the intention to eat healthier, but reported more often that they had changed their diet since diagnosis. There is ample room for improvement of lifestyle recommendations in virtually all CRC survivors. A minor part of CRC survivors expressed a need for dietary advice which was not associated with adherence to the recommendations.
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Affiliation(s)
- Renate M Winkels
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands.
| | - Linde van Lee
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Sandra Beijer
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands
| | - Martijn J Bours
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | | | - Anouk Geelen
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Meeke Hoedjes
- Department of Health Sciences and the EMGO+ Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands
| | - Floortje Mols
- Netherlands Comprehensive Cancer Organisation (IKNL), Utrecht, The Netherlands.,Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, Tilburg, The Netherlands
| | - Jeanne de Vries
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Matty P Weijenberg
- Department of Epidemiology, GROW-School for Oncology and Developmental Biology, Maastricht University, Maastricht, The Netherlands
| | - Ellen Kampman
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
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De Smedt L, Palmans S, Govaere O, Moisse M, Boeckx B, De Hertogh G, Prenen H, Van Cutsem E, Tejpar S, Tousseyn T, Sagaert X. Expression of FOXP1 and Colorectal Cancer Prognosis. Lab Med 2016; 46:299-311. [PMID: 26489674 DOI: 10.1309/lm7ihv2nji1phmxc] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Forkhead box gene P1 (FOXP1) has proven to be a valuable prognostic biomarker in lymphomas, but little is known about this gene in colorectal cancer (CRC). OBJECTIVES To investigate the expression of FOXP1 in CRC and its potential associations with outcome in CRC. METHODS We studied the expression pattern of FOXP1 retrospectively via immunohistochemistry in a series of 165 - CRC cases. Fluorescent in situ hybridization and RNA sequencing on FOXP1 knockdown cell lines were performed to investigate the mechanism of action and target genes of FOXP1. RESULTS Complete loss of nuclear FOXP1 expression was observed in 11.5% of the subjects. A total of 70.9% of subjects showed a heterogeneous FOXP1 expression pattern, and 17.6% of them had high FOXP1 expression. Impaired expression of FOXP1 was significantly correlated with reduced survival rates by multivariate analysis (P = .004). We found no chromosomal aberrations involving FOXP1 in individuals with FOXP1 negativity via immunohistochemical testing. RNA sequencing revealed that genes involved in inflammation and cell proliferation were differentially expressed after FOXP1 knockdown. CONCLUSIONS In our case series, loss of FOXP1 was associated with reduced survival rates in CRC tissue. Also, FOXP1 affects proliferation and inflammatory reaction in colorectal neoplasia.
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Affiliation(s)
- Linde De Smedt
- Translational Cell and Tissue Research Unit, Department of Imaging and Pathologie, KU Leuven, Leuven, Belgium
| | - Sofie Palmans
- Translational Cell and Tissue Research Unit, Department of Imaging and Pathologie, KU Leuven, Leuven, Belgium
| | - Olivier Govaere
- Translational Cell and Tissue Research Unit, Department of Imaging and Pathologie, KU Leuven, Leuven, Belgium
| | - Matthieu Moisse
- Vesalius Research Center, Vlaams instituut voor Biotechnologie (VIB), Leuven, Belgium Laboratory for Translational Genetics, Department of Oncology, KU Leuven Belgium
| | - Bram Boeckx
- Vesalius Research Center, Vlaams instituut voor Biotechnologie (VIB), Leuven, Belgium Laboratory for Translational Genetics, Department of Oncology, KU Leuven Belgium
| | - Gert De Hertogh
- Vesalius Research Center, Vlaams instituut voor Biotechnologie (VIB), Leuven, Belgium Laboratory for Translational Genetics, Department of Oncology, KU Leuven Belgium
| | - Hans Prenen
- Digestive Oncology Unit, Department of Oncology, University Hospitals Leuven, Belgium, Department of Pathology, University Hospitals Leuven, Belgium
| | - Erik Van Cutsem
- Digestive Oncology Unit, Department of Oncology, University Hospitals Leuven, Belgium, Department of Pathology, University Hospitals Leuven, Belgium
| | - Sabine Tejpar
- Digestive Oncology Unit, Department of Oncology, University Hospitals Leuven, Belgium, Department of Pathology, University Hospitals Leuven, Belgium
| | - Thomas Tousseyn
- Translational Cell and Tissue Research Unit, Department of Imaging and Pathologie, KU Leuven, Leuven, Belgium
| | - Xavier Sagaert
- Translational Cell and Tissue Research Unit, Department of Imaging and Pathologie, KU Leuven, Leuven, Belgium
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40
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Farghaly SA. Ovarian cancer in obese women: risk and optimal medical and surgical treatment options. ACTA ACUST UNITED AC 2016; 11:261-3. [PMID: 26102463 DOI: 10.2217/whe.15.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Samir A Farghaly
- The Joan & Sanford I. Weill Medical College, & The New York Presbyterian Hospital/Weill Cornell Medical Center, Cornell University, 525 East 68 Street, P713A, NY, USA
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Shabihkhani M, Yu SS, Yang D, Lin S, Hamilton AS, Lenz HJ, Barzi A. Metastatic Colorectal Cancer in Hispanics: Treatment Outcomes in a Treated Population. Clin Colorectal Cancer 2016; 15:e221-e227. [PMID: 27553907 DOI: 10.1016/j.clcc.2016.03.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 02/18/2016] [Accepted: 03/22/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND In United States Hispanics have disparities in the presentation and outcome of colorectal cancer (CRC) largely attributed to their late presentation and lower socioeconomic status. Impact of treatment, especially in the metastatic setting, in the observed outcome is an unexplored area. We explored the role of treatment in the outcome of metastatic CRC we performed a retrospective analysis to assess the contribution of demographics, tumor characteristics, and health care setting on survival differences. PATIENTS AND METHODS We conducted a retrospective study of patients who were treated with metastatic CRC at Los Angeles County Hospital-University of Southern California (LAC-USC, a public hospital) and Norris Comprehensive Cancer Center (NCCC, private hospital) between 2002 and 2012. Both these institutions are staffed by the same providers and therefore treatment algorithms and access to drugs were similar. We identified metastatic CRC patients who received chemotherapy from administrative records. Demographics, tumor, and treatment related factors were collected. The primary end point was time to progression (TTP: time from the first day of chemotherapy to the date of progression). Overall survival (OS) was measured from the first day of chemotherapy to death or last follow-up. Descriptive statistics were used to describe the population and chi-square, Wilcoxon, and log-rank tests were used for comparison between the groups. RESULTS A total of 242 patients, 44% Hispanic, 26% non-Hispanic whites (NHWs), 21% Asian and 9% black were included. Median TTP was 9.2 months (95% confidence interval [CI], 7.6-11.6) in Hispanics, and 20.7 months (95% CI, 9.6-27.5; P < .05) in NHWs. Median OS in Hispanics was 16.3 months (95% CI, 13.3-18.5), and in NHWs was 33.5 months (95% CI, 22.1-63.6; P < .001). Hispanics who were treated at LAC-USC had longer TTP in comparison to Hispanics at NCCC (P = .04). CONCLUSION Hispanics with metastatic CRC have shorter TTP and OS on first line therapy when adjusted for health care setting, demographics, disease characteristics, and treatment factors.
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Affiliation(s)
- Maryam Shabihkhani
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Department of Pathology, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Steven S Yu
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Dongyun Yang
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Sonia Lin
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ann S Hamilton
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA
| | - Heinz-Josef Lenz
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Afsaneh Barzi
- Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, CA; Keck School of Medicine, University of Southern California, Los Angeles, CA.
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Harvie M, Howell A, Evans DG. Can diet and lifestyle prevent breast cancer: what is the evidence? Am Soc Clin Oncol Educ Book 2016:e66-73. [PMID: 25993238 DOI: 10.14694/edbook_am.2015.35.e66] [Citation(s) in RCA: 58] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Breast cancer is the most common cancer among women in both developed and less-developed countries. Rates of breast cancer are increasing worldwide, with a particular increase in postmenopausal and estrogen receptor-positive cases. The World Cancer Research Fund (WCRF) and American Cancer Society (ACS) cancer prevention guidelines recommend maintaining a healthy weight, undertaking at least 150 minutes of moderate intensity exercise per week, limiting alcohol consumption, and eating a plant-based diet. Observational data link adherence to physical activity and alcohol guidelines throughout life to a reduced risk of developing pre- and postmenopausal breast cancer. Weight control throughout life appears to prevent cases after menopause. Adherence to a healthy dietary pattern does not have specific effects on breast cancer risk but remains important as it reduces the risk for other common diseases, such as cardiovascular disease (CVD), diabetes, and dementia. Emerging data suggest that smoking during adolescence or early adulthood increases later risk of breast cancer. Lifestyle factors appear to modify risk among high-risk women with a family history and those with typical risk of the general population, although their effects among carriers of BRCA mutations are not well defined. Recent expert reports estimate that successful lifestyle changes could prevent 25% to 30% of cases of breast cancer. These reductions will only be achieved if we can implement targeted prevention programs for high-risk women and women in population-based breast screening programs during childhood, adolescence, and early adulthood when the rapidly developing breast is particularly susceptible to carcinogenesis.
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Affiliation(s)
- Michelle Harvie
- From the Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - Anthony Howell
- From the Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
| | - D Gareth Evans
- From the Genesis Breast Cancer Prevention Centre, University Hospital of South Manchester NHS Foundation Trust, Manchester, United Kingdom
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van Dijk M, Pot GK. The effects of nutritional interventions on recurrence in survivors of colorectal adenomas and cancer: a systematic review of randomised controlled trials. Eur J Clin Nutr 2016; 70:566-73. [PMID: 26757838 DOI: 10.1038/ejcn.2015.210] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 09/28/2015] [Accepted: 11/02/2015] [Indexed: 12/14/2022]
Abstract
BACKGROUND/OBJECTIVES Nutrition and dietary supplementation may modulate outcomes in colorectal cancer (CRC) survivors. However, no recent systematic review has focused on randomised controlled trials (RCTs). The aim of this systematic review was to examine the effects of nutritional RCTs in survivors of colorectal adenomas and cancer. SUBJECTS/METHODS Medline, Embase, Scopus, Web of Science and the Cochrane Library were searched to identify research between April 2006 and January 2014. The primary outcomes were colorectal adenoma and cancer recurrence. Each included study was assessed for risk of bias. A meta-analysis using a random-effects model was performed, in which two or more RCTs investigated the same dietary intervention. RESULTS Eight completed RCTs, all in colorectal adenoma survivors, were identified, with four investigating the effect of folic acid. A meta-analysis of the four folic acid RCTs showed no statistically significant effect of folic acid on colorectal adenoma recurrence (relative risks=0.93; 95% confidence interval: 0.69, 1.25). The impact of the remaining completed RCTs, investigating antioxidant supplementation, green tea extract, prebiotic fibre and phytooestrogens/insoluble fibre, could not be reliably estimated because of the limited number and heterogeneity of the interventions. In addition, three heterogeneous ongoing RCTs were identified, investigating green tea (n=1) and eicosapentaenoic acid (n=1) in colorectal adenoma survivors and dietary modifications (n=1) in CRC survivors in remission. CONCLUSIONS Overall, this systematic review highlights the need for further research, especially in CRC survivors, as we identified no completed and only one ongoing RCT in this population.
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Affiliation(s)
- M van Dijk
- King's College London, Diabetes and Nutritional Sciences Division, School of Medicine, Franklin-Wilkins Building, London, UK
| | - G K Pot
- King's College London, Diabetes and Nutritional Sciences Division, School of Medicine, Franklin-Wilkins Building, London, UK
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Carr PR, Jansen L, Walter V, Kloor M, Roth W, Bläker H, Chang-Claude J, Brenner H, Hoffmeister M. Associations of red and processed meat with survival after colorectal cancer and differences according to timing of dietary assessment. Am J Clin Nutr 2016; 103:192-200. [PMID: 26607936 DOI: 10.3945/ajcn.115.121145] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2015] [Accepted: 10/07/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Little is known about the prognostic impact of red and processed meat intake or about changes in consumption after a diagnosis of colorectal cancer (CRC). OBJECTIVES We investigated associations of baseline red and processed meat with survival outcomes and explored changes in intake among CRC survivors 5 y after diagnosis. DESIGN A total of 3122 patients diagnosed with CRC between 2003 and 2010 were followed for a median of 4.8 y [DACHS (Darmkrebs: Chancen der Verhütung durch Screening) study]. Patients provided information on diet and other factors in standardized questionnaires at baseline and at the 5-y follow-up. Cox proportional hazards regression models were used to estimate HRs and 95% CIs. RESULTS Among patients with stage I-III CRC, baseline red and processed meat intake was not associated with overall (>1 time/d compared with <1 time/d; HR: 0.85; 95% CI: 0.67, 1.09), CRC-specific (HR: 0.83; 95% CI: 0.61, 1.14), cardiovascular disease-specific (HR: 0.92; 95% CI: 0.51, 1.68), non-CRC-specific (HR: 0.88; 95% CI: 0.59, 1.30), and recurrence-free (HR: 1.03; 95% CI: 0.80, 1.33) survival; results among stage IV patients were comparable. An association with worse overall survival was found among patients with Kirsten rat sarcoma viral oncogene homolog (KRAS)-mutated CRC (HR: 1.99; 95% CI: 1.10, 3.56) but not with microsatellite instability or CpG island methylator phenotype (CIMP) positivity. A much lower proportion of survivors reported daily consumption of red and processed meat at the 5-y follow-up than at baseline (concordance rate: 39%; κ-value: 0.10; 95% CI: 0.07, 0.13). CONCLUSIONS Our findings suggest that baseline red and processed meat intake is not associated with poorer survival among patients with CRC. The potential interaction with KRAS mutation status warrants further evaluation. Major changes in consumption measured at the 5-y follow-up may have had an impact on our survival estimates.
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Affiliation(s)
| | - Lina Jansen
- Divisions of Clinical Epidemiology and Aging Research
| | - Viola Walter
- Divisions of Clinical Epidemiology and Aging Research
| | | | - Wilfried Roth
- Unit of Molecular Tumor Pathology; and Pathology, Institute of Pathology, University of Heidelberg, Heidelberg, Germany; and
| | - Hendrik Bläker
- Institute of Pathology, Charité University Medicine, Berlin, Germany
| | | | - Hermann Brenner
- Divisions of Clinical Epidemiology and Aging Research, Preventive Oncology; German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
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Tian Y, Wang K, Li J, Wang J, Wang Z, Fan Y, Ye Y, Ji G, Li Y. The association between serum lipids and colorectal neoplasm: a systemic review and meta-analysis. Public Health Nutr 2015; 18:3355-70. [PMID: 25776573 PMCID: PMC10271749 DOI: 10.1017/s1368980015000646] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Revised: 09/30/2014] [Accepted: 01/23/2015] [Indexed: 12/18/2022]
Abstract
OBJECTIVE There have been inconsistent results published regarding the relationship between dyslipidaemia and an increased risk of colorectal neoplasia (CRN), including colorectal adenoma (CRA) and colorectal cancer (CRC). We conducted a meta-analysis to explore the relationship between dyslipidaemia and CRN. DESIGN We identified studies by performing a literature search using PubMed, EMBASE and the Science Citation Index through October 2013. SETTING We analysed thirty-three independent studies reporting the association between CRN and at least one of the selected lipid components, including total cholesterol (TC), TAG, HDL-cholesterol (HDL-C) and LDL-cholesterol (LDL-C). SUBJECTS CRN cases (n 21 809) were identified. RESULTS Overall, people with high levels of serum TAG (risk ratio (RR)=1.08; 95% CI 1.05, 1.12, P<0.00001) and LDL-C (RR=1.07; 95% CI 1.00, 1.14, P=0.04) presented an increased prevalence of CRN. Subgroup analyses revealed that high levels of serum TC (RR=1.04; 95% CI 1.01, 1.09, P=0.02), TAG (RR=1.06; 95% CI 1.03, 1.10, P=0.0009) and LDL-C (RR=1.11; 95% CI 1.04, 1.19, P=0.003) increased the risk of CRA but not of CRC. No association between serum HDL-C and risk for CRN (including CRA and CRC) was observed. CONCLUSIONS Both TAG and LDL-C were significantly associated with an increasing prevalence of CRN. High levels of serum TC, TAG and LDL-C were positively associated with CRA but not with CRC. No significant association was observed between levels of serum HDL-C and CRN.
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Affiliation(s)
- Yun Tian
- Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Keming Wang
- Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Juan Li
- Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Jirong Wang
- Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Zhaoxia Wang
- Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yingrui Fan
- Department of Oncology, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Ying Ye
- Emergency Center, Affiliated Hospital of Xuzhou Medical College, Xuzhou, People’s Republic of China
| | - Guozhong Ji
- Institute of Digestive Endoscopy and Medical Center for Digestive Diseases, The Second Affiliated Hospital of Nanjing Medical University, Nanjing, People’s Republic of China
| | - Yi Li
- Department of General Surgery, Jinling Hospital, Medical School of Nanjing University, No. 305 East Zhongshan Road, Nanjing 210002, People’s Republic of China
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Manigandan K, Manimaran D, Jayaraj RL, Elangovan N, Dhivya V, Kaphle A. Taxifolin curbs NF-κB-mediated Wnt/β-catenin signaling via up-regulating Nrf2 pathway in experimental colon carcinogenesis. Biochimie 2015; 119:103-12. [PMID: 26482805 DOI: 10.1016/j.biochi.2015.10.014] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2015] [Accepted: 10/14/2015] [Indexed: 01/03/2023]
Abstract
Aberrations in homeostasis mechanisms including Nrf2, inflammatory, and Wnt/β-catenin signaling are the major causative factors implicated in colon cancer development. Hence blocking these pathways through natural interventions pave a new channel for colon cancer prevention. Earlier, we reported the chemopreventive effect of taxifolin (TAX) against colon carcinogenesis. In this study, we aimed to understand the ability of TAX, to modulate the Nrf2, inflammatory and Wnt/β-catenin cascades on 1, 2-dimethyl hydrazine (DMH)-induced mouse colon carcinogenesis. In addition, in silico molecular docking studies were performed to evaluate the binding affinity between TAX and target proteins (Nrf2, β-catenin, and TNF-α). We perceived that the increase of serum marker enzyme levels (CEA and LDH) and mast cell infiltration that occurs in the presence of DMH is inverted after TAX treatment. Immunoblot expression and docking analysis revealed that TAX could induce antioxidant response pathway, confirming the enhanced level of Nrf2 protein. It also inhibited NF-κB and Wnt signaling by down-regulating the levels of regulatory metabolites such as TNF-α, COX-2, β-catenin, and Cyclin-D1. Collectively, results of our hypothesis shown that TAX is an effective chemopreventive agent capable of modulating inflammatory, Wnt and antioxidant response pathway proteins in tumor microenvironment which explicating its anticancer property.
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Affiliation(s)
- Krishnan Manigandan
- Department of Biotechnology, School of Biosciences, Periyar University, Salem, 636011 Tamilnadu, India
| | - Dharmar Manimaran
- Department of Biotechnology, School of Biosciences, Periyar University, Salem, 636011 Tamilnadu, India
| | - Richard L Jayaraj
- Harborview Research & Training Building, University of Washington, School of Medicine, Seattle, WA 98104, United States
| | - Namasivayam Elangovan
- Department of Biotechnology, School of Biosciences, Periyar University, Salem, 636011 Tamilnadu, India.
| | - Velumani Dhivya
- Translational Research Lab, Department of Biotechnology, Bharathiar University, Coimbatore, 641046 Tamilnadu, India
| | - Anubhav Kaphle
- Department of Biotechnology, Siddaganga Institute of Technology, Tumakuru, 5720103 Karnataka, India
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Kenzik K, Pisu M, Fouad MN, Martin MY. Are long-term cancer survivors and physicians discussing health promotion and healthy behaviors? J Cancer Surviv 2015. [PMID: 26210659 DOI: 10.1007/s11764-015-0473-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE This study aimed to (1) describe the proportion of survivors reporting that a physician discussed strategies to improve health and (2) identify which groups are more likely to report these discussions. METHODS Lung cancer and colorectal cancer (CRC) survivors (>5 years from diagnosis) (n = 874) completed questionnaires, including questions on whether, in the previous year, a physician discussed (1) strategies to improve health, (2) exercise, and (3) diet habits. Chi-square tests and logistic regression models were used to examine whether the likelihood of these discussions varied by demographic and clinical characteristics. RESULTS Fifty-nine percent reported that a physician discussed strategies to improve health and exercise, 44% reported discussions on diet, and 24% reported no discussions. Compared to their counterparts, survivors with lower education were less likely to report discussing all three areas, but survivors with diabetes were more likely. Survivors ≥ 65 years old were less likely to report discussing strategies to improve health and diet. Males and CRC survivors reported discussing diet more than their female and lung cancer counterparts, respectively. CONCLUSION The frequency of health promotion discussions varied across survivor characteristics. Discussions were more frequently reported by some groups, e.g., survivors with diabetes, or among individuals less likely to engage in healthy behaviors. In contrast, males and older and less educated survivors were less likely to have these discussions. IMPLICATIONS FOR CANCER SURVIVORS Decreasing physician barriers and encouraging patients to discuss health promotion, especially in the context of clinical care for older survivors and those with low education, is essential for promoting the overall well-being of cancer survivors.
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Affiliation(s)
- Kelly Kenzik
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Maria Pisu
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mona N Fouad
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michelle Y Martin
- School of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. .,Division of Preventive Medicine, School of Medicine, University of Alabama at Birmingham, MT617, Birmingham, AL, 35233, USA.
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Li JT, Zhong BY, Xu HH, Qiao SY, Wang G, Huang J, Fan HZ, Zhao HC. Associations between NBS1 Polymorphisms and Colorectal Cancer in Chinese Population. PLoS One 2015; 10:e0132332. [PMID: 26186548 PMCID: PMC4505902 DOI: 10.1371/journal.pone.0132332] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 06/14/2015] [Indexed: 12/13/2022] Open
Abstract
As the central protein of the double strand breaks (DSB)-induced DNA repair pathway, NBS1 participates in detecting the DSBs and plays an essential role in maintaining genomic stability. Single nucleotide polymorphisms (SNPs) in NBS1 gene were commonly tested that associated with the susceptibility to multiple cancers, but the results remained controversial. Thus, we conducted two independent hospital-based case-control studies comprising 1,072 colorectal cancer patients and 1,263 controls to evaluate the association between four NBS1 SNPs and colorectal cancer risk. The result showed that rs2735383C/G polymorphism in the 3'-untranslated region (UTR) of NBS1 was significantly associated with risk of colorectal cancer using logistic regression (P<10(-4)). Furthermore, we observed that rs2735383CC genotype was associated with substantially increased risk of colorectal cancer (odds ratio=1.55, 95% confidence interval=1.27-1.94), compared with the rs2735383GC+GG genotypes. Further functional experiments demonstrated that the rs2735383C allele in the NBS1 disrupted the binding affinity of has-miR-509-5p to the NBS1 3'-UTR in colorectal cancer cells, affecting the NBS1 transcriptional activity and expression level. In conclusion, current evidence suggests that the rs2735383C/G polymorphism might contribute to the risk for colorectal cancer.
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Affiliation(s)
- Jing-Tao Li
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China
| | - Bao-Yuan Zhong
- Department of general surgery, First Affiliated Hospital of Gannan Medical College, Ganzhou, China
| | - Hui-Hui Xu
- Institute of Clinical Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Sheng-Yan Qiao
- Institute of Clinical Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Gui Wang
- Institute of Clinical Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Jing Huang
- Institute of Clinical Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Hui-Zhen Fan
- Department of Gastroenterology, The People’s Hospital of Yichun City, Yichun, China
- * E-mail: (HCZ); (HZF)
| | - Hong-Chuan Zhao
- Department of Gastroenterology, China-Japan Friendship Hospital, Beijing, China
- * E-mail: (HCZ); (HZF)
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Romaguera D, Ward H, Wark PA, Vergnaud AC, Peeters PH, van Gils CH, Ferrari P, Fedirko V, Jenab M, Boutron-Ruault MC, Dossus L, Dartois L, Hansen CP, Dahm CC, Buckland G, Sánchez MJ, Dorronsoro M, Navarro C, Barricarte A, Key TJ, Trichopoulou A, Tsironis C, Lagiou P, Masala G, Pala V, Tumino R, Vineis P, Panico S, Bueno-de-Mesquita HB, Siersema PD, Ohlsson B, Jirström K, Wennberg M, Nilsson LM, Weiderpass E, Kühn T, Katzke V, Khaw KT, Wareham NJ, Tjønneland A, Boeing H, Quirós JR, Gunter MJ, Riboli E, Norat T. Pre-diagnostic concordance with the WCRF/AICR guidelines and survival in European colorectal cancer patients: a cohort study. BMC Med 2015; 13:107. [PMID: 25948112 PMCID: PMC4423114 DOI: 10.1186/s12916-015-0332-5] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2014] [Accepted: 03/20/2015] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cancer survivors are advised to follow lifestyle recommendations on diet, physical activity, and body fatness proposed by the World Cancer Research Fund/American Institute of Cancer Research (WCRF/AICR) for cancer prevention. Previous studies have demonstrated that higher concordance with these recommendations measured using an index score (the WCRF/AICR score) was associated with lower cancer incidence and mortality. The aim of this study was to evaluate the association between pre-diagnostic concordance with WCRF/AICR recommendations and mortality in colorectal cancer (CRC) patients. METHODS The association between the WCRF/AICR score (score range 0-6 in men and 0-7 in women; higher scores indicate greater concordance) assessed on average 6.4 years before diagnosis and CRC-specific (n = 872) and overall mortality (n = 1,113) was prospectively examined among 3,292 participants diagnosed with CRC in the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (mean follow-up time after diagnosis 4.2 years). Multivariable Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) for mortality. RESULTS The HRs (95% CIs) for CRC-specific mortality among participants in the second (score range in men/women: 2.25-2.75/3.25-3.75), third (3-3.75/4-4.75), and fourth (4-6/5-7) categories of the score were 0.87 (0.72-1.06), 0.74 (0.61-0.90), and 0.70 (0.56-0.89), respectively (P for trend <0.0001), compared to participants with the lowest concordance with the recommendations (category 1 of the score: 0-2/0-3). Similar HRs for overall mortality were observed (P for trend 0.004). Meeting the recommendations on body fatness and plant food consumption were associated with improved survival among CRC cases in mutually adjusted models. CONCLUSIONS Greater concordance with the WCRF/AICR recommendations on diet, physical activity, and body fatness prior to CRC diagnosis is associated with improved survival among CRC patients.
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Affiliation(s)
- Dora Romaguera
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
- Instituto de Investigación Sanitaria de Palma (IdISPa), Hospital Universitario Son Espases, Research Unit I-1, Ctra. de Valldemossa 79, 07010, Palma de Mallorca, Spain.
- CIBER Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
| | - Heather Ward
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
| | - Petra A Wark
- Global eHealth Unit, Department of Primary Care and Public Health, School of Public Health, Imperial College London, The Reynolds Building, St Dunstan's Road, London, W6 8RP, UK.
| | - Anne-Claire Vergnaud
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
| | - Petra H Peeters
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500 3508 GA, Utrecht, The Netherlands.
| | - Carla H van Gils
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, P.O. Box 85500 3508 GA, Utrecht, The Netherlands.
| | - Pietro Ferrari
- International Agency for Cancer Research (IARC), 150 Cours Albert Thomas, 69372, Lyon, CEDEX 08, France.
| | - Veronika Fedirko
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Rd, Atlanta, GA, USA.
- Winship Cancer Institute, Emory University, 1518 Clifton Rd, Atlanta, GA, 30322, USA.
| | - Mazda Jenab
- International Agency for Cancer Research (IARC), 150 Cours Albert Thomas, 69372, Lyon, CEDEX 08, France.
| | - Marie-Christine Boutron-Ruault
- Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), U1018, Team 9, 114 rue Édouard Vaillant, 94805, Villejuif, Cedex, France.
- Univ Paris Sud, UMRS 1018, 114 rue Édouard Vaillant 94805, Villejuif, France.
- Gustave Roussy, 114 rue Édouard Vaillant 94805, Villejuif, France.
| | - Laure Dossus
- Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), U1018, Team 9, 114 rue Édouard Vaillant, 94805, Villejuif, Cedex, France.
- Univ Paris Sud, UMRS 1018, 114 rue Édouard Vaillant 94805, Villejuif, France.
- Gustave Roussy, 114 rue Édouard Vaillant 94805, Villejuif, France.
| | - Laureen Dartois
- Inserm (Institut National de la Santé et de la Recherche Médicale), Centre for Research in Epidemiology and Population Health (CESP), U1018, Team 9, 114 rue Édouard Vaillant, 94805, Villejuif, Cedex, France.
- Univ Paris Sud, UMRS 1018, 114 rue Édouard Vaillant 94805, Villejuif, France.
- Gustave Roussy, 114 rue Édouard Vaillant 94805, Villejuif, France.
| | - Camilla Plambeck Hansen
- Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, DK-8000, Aarhus C, Denmark.
| | - Christina Catherine Dahm
- Section for Epidemiology, Department of Public Health, Aarhus University, Bartholins Allé 2, DK-8000, Aarhus C, Denmark.
| | - Genevieve Buckland
- Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO-IDIBELL), Avda. de la Granvia de l'Hospitalet, 199-203, 08908, Barcelona, Spain.
| | - María José Sánchez
- Escuela Andaluza de Salud Pública, Instituto de Investigación Biosanitaria ibs. GRANADA, Hospitales Universitarios de Granada/Universidad de Granada, Campus Universitario de Cartuja, Cuesta del Observatorio, 4, 18011, Granada, Spain.
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
| | - Miren Dorronsoro
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
- Public Health Direction and Biodonostia Basque Regional Health Department, Avenida Navarra 4, 20013, San Sebastian, Spain.
| | - Carmen Navarro
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
- Department of Epidemiology, Murcia Regional Health Council, Ronda de Levante, 11, 30008, Murcia, Spain.
- Department of Health and Social Sciences, Universidad de Murcia, Campus Universitario de Espinardo, s/n, 30100 Espinardo, Murcia, Spain.
| | - Aurelio Barricarte
- CIBER de Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, C/ Monforte de Lemos 3-5. Pabellón 11. Planta 0. 28029, Madrid, Spain.
- Navarre Public Health Institute, C/ Leyre, 15 31003, Pamplona, Spain.
| | - Timothy J Key
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Roosevelt Drive, Oxford, OX3 7LF, UK.
| | - Antonia Trichopoulou
- Hellenic Health Foundation, 13 Kaisareias Street, Athens, GR-115 27, Greece.
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens, GR-115 27, Greece.
| | - Christos Tsironis
- Hellenic Health Foundation, 13 Kaisareias Street, Athens, GR-115 27, Greece.
| | - Pagona Lagiou
- Bureau of Epidemiologic Research, Academy of Athens, 23 Alexandroupoleos Street, Athens, GR-115 27, Greece.
- Department of Hygiene, Epidemiology and Medical Statistics, University of Athens Medical School, 75 M. Asias Street, Goudi, GR-115 27, Athens, Greece.
- Department of Epidemiology, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA, 02115, USA.
| | - Giovanna Masala
- Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Institute - ISPO, Via delle Oblate 4, 50141, Florence, Italy.
| | - Valeria Pala
- Epidemiology and Prevention Unit, Fondazione IRCCS, Istituto Nazionale dei Tumori, Via Giacomo Venezian, 1, Milan, Italy.
| | - Rosario Tumino
- Cancer Registry and Histopathology Unit, "Civic - M.P. Arezzo" Hospital, Via Dante Alighieri 109, I-97100, ASP, Ragusa, Italy.
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
- HuGeF Foundation, via Nizza 52, Turin, Italy.
| | - Salvatore Panico
- Dipartimento di Medicina Clinica e Chirurgia, Federico II University, VIA PANSINI 5, 80131, Naples, Italy.
| | - H Bas Bueno-de-Mesquita
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
- Department for Determinants of Chronic Diseases (DCD), National Institute for Public Health and the Environment (RIVM), Antonie van Leeuwenhoeklaan 9, 3721 MA, Bilthoven / PO Box 1, 3720 BA, Bilthoven, The Netherlands.
- Department of Gastroenterology and Hepatology, University Medical Centre, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
- Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Lembah Pantai, 50603, Kuala Lumpur, Malaysia.
| | - Peter D Siersema
- Department of Gastroenterology and Hepatology, University Medical Centre, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
| | - Bodil Ohlsson
- Division of Internal Medicine, Department of Clinical Sciences, Skane University Hospital, Malmo, Lund University, Inga-Maria Nilssons gata 32, 205 02, Lund, Sweden.
| | - Karin Jirström
- Department of Clinical Sciences, Division of Oncology and Pathology, Lund University, Barngatan 2B, SE- 221 85, Lund, Sweden.
| | - Maria Wennberg
- Public Health and Clinical Medicine, Nutritional Research, Umeå University, S-901 87, Umeå, Sweden.
| | - Lena M Nilsson
- Arctic Research Centre, Umeå University, S-901 87, Umeå, Sweden.
| | - Elisabete Weiderpass
- Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, ISM - Universitetet i Tromsø, 9037, Tromsø, Norway.
- Department of Research, Cancer Registry of Norway, P.B. 5313, Majorstuen, 0304, Oslo, Norway.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, PO Box 281, 171 77, Stockholm, Sweden.
- Department of Genetic Epidemiology, Folkhälsan Research Center, Folkhälsan Research Center, Biomedicum 1, Haartmansgatan 8, PB 63 (B336b), FI-00014 University of Helsinki, Helsinki, Finland.
| | - Tilman Kühn
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology Im Neuenheimer Feld 581, D-69120, Heidelberg, Germany.
| | - Verena Katzke
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology Im Neuenheimer Feld 581, D-69120, Heidelberg, Germany.
| | - Kay-Tee Khaw
- University of Cambridge School of Clinical Medicine, Clinical Gerontology Unit Box 251, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK.
| | - Nick J Wareham
- MRC Epidemiology Unit, University of Cambridge, Addenbrooke's Hospital, Cambridge, CB2 2QQ, UK.
| | - Anne Tjønneland
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100, Copenhagen, Denmark.
| | - Heiner Boeing
- Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke, Nuthetal, 69120, Germany.
| | - José R Quirós
- Public Health Directorate, Ciriaco Miguel Vigil 9, Oviedo, 33417, Asturias, Spain.
| | - Marc J Gunter
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
| | - Elio Riboli
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
| | - Teresa Norat
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St. Mary's Campus, Norfolk Place, W2 1PG, London, UK.
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Mols F, Beijers AJM, Vreugdenhil G, Verhulst A, Schep G, Husson O. Chemotherapy-induced peripheral neuropathy, physical activity and health-related quality of life among colorectal cancer survivors from the PROFILES registry. J Cancer Surviv 2015; 9:512-22. [PMID: 25876556 DOI: 10.1007/s11764-015-0427-1] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2014] [Accepted: 01/12/2015] [Indexed: 01/03/2023]
Abstract
PURPOSE To gain insight into the association of physical activity (PA), chemotherapy-induced peripheral neuropathy (CIPN) and health-related quality of life among colorectal cancer survivors, up to 11 years after diagnosis. METHODS Data of the second data wave of a Dutch prospective population-based survey among colorectal cancer survivors diagnosed between 2000 and 2009 as registered by the Eindhoven Cancer Registry was used. Eighty-three percent (n = 1648) of patients filled out the EORTC QLQ-C30 and the EORTC QLQ-CIPN20 of which 506 patients (31%) were treated with chemotherapy. RESULTS Treatment with chemotherapy was associated with a higher percentage of patients reporting CIPN symptoms regardless of PA. Furthermore, not meeting the Dutch PA guideline of 150 min of moderate to vigorous PA a week was associated with more CIPN among patients treated with chemotherapy. Also patients not treated with chemotherapy reported CIPN-like symptoms, especially when not meeting the PA guideline. Statistically significant and clinically relevant worse scores on almost all EORTC QLQ-C30 subscales were reported by those not meeting the PA guideline compared to those who did meet the guideline, regardless of CIPN symptoms. However, these differences were more pronounced in the group with many CIPN symptoms (e.g. upper 30%). IMPLICATIONS FOR CANCER SURVIVORS Alertness among health care professionals and patients for the importance of PA is warranted, as meeting the PA guideline was associated with less CIPN-like symptoms and a higher health-related quality of life regardless of treatment with chemotherapy.
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Affiliation(s)
- Floortje Mols
- CoRPS-Center of Research on Psychology in Somatic diseases, Department of Medical and Clinical Psychology, Tilburg University, PO Box 90153, 5000, LE, Tilburg, The Netherlands,
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