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 B Benson III, Devin S. Wigler, Alan Venook, Charles S. Fuchs

*Corresponding author for this work

Research output: Contribution to journalArticle

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Abstract

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
Volume104
Issue number22
DOIs
StatePublished - Nov 21 2012

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Colonic Neoplasms
Recurrence
Survival
Neoplasms
Disease-Free Survival
Body Mass Index
Carbohydrates
Confidence Intervals
Glycemic Index
Mortality
Adjuvant Chemotherapy
Glycemic Load
Fructose
Observational Studies
Prospective Studies

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Meyerhardt, Jeffrey A. ; Sato, Kaori ; Niedzwiecki, Donna ; Ye, Cynthia ; Saltz, Leonard B. ; Mayer, Robert J. ; Mowat, Rex B. ; Whittom, Renaud ; Hantel, Alexander ; Benson III, Al B ; Wigler, Devin S. ; Venook, Alan ; Fuchs, Charles S. / Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer : Findings from CALGB 89803. In: Journal of the National Cancer Institute. 2012 ; Vol. 104, No. 22. pp. 1702-1711.
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title = "Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: Findings from CALGB 89803",
abstract = "Background The influence of glycemic load and related measures on survival among colon cancer patients remains largely unknown.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.",
author = "Meyerhardt, {Jeffrey A.} and Kaori Sato and Donna Niedzwiecki and Cynthia Ye and Saltz, {Leonard B.} and Mayer, {Robert J.} and Mowat, {Rex B.} and Renaud Whittom and Alexander Hantel and {Benson III}, {Al B} and Wigler, {Devin S.} and Alan Venook and Fuchs, {Charles S.}",
year = "2012",
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Meyerhardt, JA, Sato, K, Niedzwiecki, D, Ye, C, Saltz, LB, Mayer, RJ, Mowat, RB, Whittom, R, Hantel, A, Benson III, AB, Wigler, DS, Venook, A & Fuchs, CS 2012, 'Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: Findings from CALGB 89803', Journal of the National Cancer Institute, vol. 104, no. 22, pp. 1702-1711. https://doi.org/10.1093/jnci/djs399

Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer : Findings from CALGB 89803. / Meyerhardt, Jeffrey A.; Sato, Kaori; Niedzwiecki, Donna; Ye, Cynthia; Saltz, Leonard B.; Mayer, Robert J.; Mowat, Rex B.; Whittom, Renaud; Hantel, Alexander; Benson III, Al B; Wigler, Devin S.; Venook, Alan; Fuchs, Charles S.

In: Journal of the National Cancer Institute, Vol. 104, No. 22, 21.11.2012, p. 1702-1711.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer

T2 - Findings from CALGB 89803

AU - Meyerhardt, Jeffrey A.

AU - Sato, Kaori

AU - Niedzwiecki, Donna

AU - Ye, Cynthia

AU - Saltz, Leonard B.

AU - Mayer, Robert J.

AU - Mowat, Rex B.

AU - Whittom, Renaud

AU - Hantel, Alexander

AU - Benson III, Al B

AU - Wigler, Devin S.

AU - Venook, Alan

AU - Fuchs, Charles S.

PY - 2012/11/21

Y1 - 2012/11/21

N2 - 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.

AB - 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.

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DO - 10.1093/jnci/djs399

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