TY - JOUR
T1 - Dietary insulin load and cancer recurrence and survival in patients with stage III colon cancer
T2 - Findings from CALGB 89803 (Alliance)
AU - Morales-Oyarvide, Vicente
AU - Yuan, Chen
AU - Babic, Ana
AU - Zhang, Sui
AU - Niedzwiecki, Donna
AU - Brand-Miller, Jennie C.
AU - Sampson-Kent, Laura
AU - Ye, Xing
AU - Li, Yanping
AU - Saltz, Leonard B.
AU - Mayer, Robert J.
AU - Mowat, Rex B.
AU - Whittom, Renaud
AU - Hantel, Alexander
AU - Benson, Al
AU - Atienza, Daniel
AU - Messino, Michael
AU - Kindler, Hedy
AU - Venook, Alan
AU - Ogino, Shuji
AU - Wu, Kana
AU - Willett, Walter C.
AU - Giovannucci, Edward L.
AU - Wolpin, Brian M.
AU - Meyerhardt, Jeffrey A.
AU - Fuchs, Charles S.
AU - Ng, Kimmie
N1 - Funding Information:
This work was supported by the National Cancer Institute of the National Institutes of Health (U10CA032291, U10CA041287, U10CA045808, U10CA077651, U10CA138561, U10CA180791, U10CA180836, and U10CA180867; U10CA180821 and U10CA180882 to the Alliance for Clinical Trials in Oncology; R35CA197735 to SO; R01CA118553, R01CA169141, and P50CA127003 to CSF; R01CA149222 to JAM; K07CA148894 and R01CA205406 to KN); the Project P Fund to CSF; and Stand Up to Cancer Colorectal Cancer Dream Team Grant to CSF.
Publisher Copyright:
© The Author(s) 2018. Published by Oxford University Press. All rights reserved.
PY - 2019/2/1
Y1 - 2019/2/1
N2 - Background: Evidence suggests that diets inducing postprandial hyperinsulinemia may be associated with increased cancer-related mortality. The goal of this study was to assess the influence of postdiagnosis dietary insulin load and dietary insulin index on outcomes of stage III colon cancer patients. Methods: We conducted a prospective observational study of 1023 patients with resected stage III colon cancer enrolled in an adjuvant chemotherapy trial who reported dietary intake halfway through and six months after chemotherapy. We evaluated the association of dietary insulin load and dietary insulin index with cancer recurrence and survival using Cox proportional hazards regression adjusted for potential confounders; statistical tests were two-sided. Results: High dietary insulin load had a statistically significant association with worse disease-free survival (DFS), comparing the highest vs lowest quintile (adjusted hazard ratio [HR] = 2.77, 95% confidence interval [CI] = 1.90 to 4.02, Ptrend < .001). High dietary insulin index was also associated with worse DFS (highest vs lowest quintile, HR = 1.75, 95% CI = 1.22 to 2.51, Ptrend = .01). The association between higher dietary insulin load and worse DFS differed by body mass index and was strongest among patients with obesity (HR = 3.66, 95% CI = 1.88 to 7.12, Pinteraction = .04). The influence of dietary insulin load on cancer outcomes did not differ by mutation status of KRAS, BRAF, PIK3CA, TP53, or microsatellite instability. Conclusions: Patients with resected stage III colon cancer who consumed a high-insulinogenic diet were at increased risk of recurrence and mortality. These findings support the importance of dietary management following resection of colon cancer, and future research into underlying mechanisms of action is warranted.
AB - Background: Evidence suggests that diets inducing postprandial hyperinsulinemia may be associated with increased cancer-related mortality. The goal of this study was to assess the influence of postdiagnosis dietary insulin load and dietary insulin index on outcomes of stage III colon cancer patients. Methods: We conducted a prospective observational study of 1023 patients with resected stage III colon cancer enrolled in an adjuvant chemotherapy trial who reported dietary intake halfway through and six months after chemotherapy. We evaluated the association of dietary insulin load and dietary insulin index with cancer recurrence and survival using Cox proportional hazards regression adjusted for potential confounders; statistical tests were two-sided. Results: High dietary insulin load had a statistically significant association with worse disease-free survival (DFS), comparing the highest vs lowest quintile (adjusted hazard ratio [HR] = 2.77, 95% confidence interval [CI] = 1.90 to 4.02, Ptrend < .001). High dietary insulin index was also associated with worse DFS (highest vs lowest quintile, HR = 1.75, 95% CI = 1.22 to 2.51, Ptrend = .01). The association between higher dietary insulin load and worse DFS differed by body mass index and was strongest among patients with obesity (HR = 3.66, 95% CI = 1.88 to 7.12, Pinteraction = .04). The influence of dietary insulin load on cancer outcomes did not differ by mutation status of KRAS, BRAF, PIK3CA, TP53, or microsatellite instability. Conclusions: Patients with resected stage III colon cancer who consumed a high-insulinogenic diet were at increased risk of recurrence and mortality. These findings support the importance of dietary management following resection of colon cancer, and future research into underlying mechanisms of action is warranted.
KW - Antiviral
KW - Influenza
KW - Polymerase inhibitors
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U2 - 10.1093/jnci/djy098
DO - 10.1093/jnci/djy098
M3 - Article
C2 - 30726946
AN - SCOPUS:85061595414
SN - 0027-8874
VL - 111
SP - 170
EP - 179
JO - Journal of the National Cancer Institute
JF - Journal of the National Cancer Institute
IS - 2
ER -
