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

Jeffrey A. Meyerhardt*, Kaori Sato, Donna Niedzwiecki, Cynthia Ye, Leonard B. Saltz, Robert J. Mayer, Rex B. Mowat, Renaud Whittom, Alexander Hantel, Al Benson, Devin S. Wigler, Alan Venook, Charles S. Fuchs

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

99 Scopus citations


Background The influence of glycemic load and related measures on survival among colon cancer patients remains largely unknown.MethodsWe conducted a prospective, observational study of 1011 stage III colon cancer patients reporting dietary intake during and 6 months after participation in an adjuvant chemotherapy trial. We examined the influence of glycemic load, glycemic index, fructose, and carbohydrate intakes on cancer recurrence and mortality using Cox proportional hazards regression; all tests of statistical significance were two-sided.ResultsStage III colon cancer patients in the highest quintile of dietary glycemic load experienced an adjusted hazard ratio (HR) for disease-free survival of 1.79 (95% confidence interval [CI] 1.29 to 2.48), compared with those in the lowest quintile (Ptrend across quintiles <.001). Increased glycemic load was associated with similar detriments in recurrence-free (Ptrend across quintiles <.001) and overall survival (Ptrend across quintiles <.001). These associations differed statistically significant by body mass index (BMI) (P interaction .01). Whereas glycemic load was not associated with disease-free survival in patients with BMI < 25kg/m2, higher glycemic load was statistically significant associated with worse disease-free survival among overweight or obese participants (BMI < 25kg/m2; HR 2.26; 95% CI 1.53 to 3.32; Ptrend across quintiles <.001). Increasing total carbohydrate intake was similarly associated with inferior disease-free, recurrence-free, and overall survival (Ptrend across quintiles <.001).ConclusionHigher dietary glycemic load and total carbohydrate intake were statistically significant associated with an increased risk of recurrence and mortality in stage III colon cancer patients. These findings support the role of energy balance factors in colon cancer progression and may offer potential opportunities to improve patient survival.

Original languageEnglish (US)
Pages (from-to)1702-1711
Number of pages10
JournalJournal of the National Cancer Institute
Issue number22
StatePublished - Nov 21 2012

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

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