TY - JOUR
T1 - Nut consumption and survival in patients with stage III colon cancer
T2 - Results from CALGB 89803 (Alliance)
AU - Fadelu, Temidayo
AU - Zhang, Sui
AU - Niedzwiecki, Donna
AU - Ye, Xing
AU - Saltz, Leonard B.
AU - Mayer, Robert J.
AU - Mowat, Rex B.
AU - Whittom, Renaud
AU - Hantel, Alexander
AU - Benson, Al B.
AU - Atienza, Daniel M.
AU - Messino, Michael
AU - Kindler, Hedy L.
AU - Venook, Alan
AU - Ogino, Shuji
AU - Ng, Kimmie
AU - Wu, Kana
AU - Willett, Walter
AU - Giovannucci, Edward
AU - Meyerhardt, Jeffrey
AU - Bao, Ying
AU - Fuchs, Charles S.
N1 - Funding Information:
Supported by the National Cancer Institute of the National Institutes of Health under Awards No. U10CA180821 and U10CA180882 (to Alliance for Clinical Trials in Oncology), U10CA180820 (to Eastern Cooperative Oncology Group–American College of Radiology Imaging Network), and U10CA180888 (to Southwest Oncology Group). Also supported by Grants No. U10CA60138, U10CA138561, U10CA180791, U10CA180836, U10CA180867, and UG1CA189858, and the Pharmacia & Upjohn Company, now Pfizer Oncology. C.S.F., K.N., J.M., D.N., and X.Y. are supported in part by grants from the National Cancer Institute (Grants No. K07 CA148894, R01 CA118553, R01 CA149222, R01 CA169141, and P50 CA127003). Y.B. is supported in part by Grant No. P30 DK046200 from the National Institutes of Health and the International Tree Nut Council Nutrition Research and Education Foundation. S.O. is supported in part by Grant No. R35 CA197735 from the National Institutes of Health.
Publisher Copyright:
© 2018 by American Society of Clinical Oncology.
PY - 2018/4/10
Y1 - 2018/4/10
N2 - Purpose Observational studies have reported increased colon cancer recurrence and mortality in patients with states of hyperinsulinemia, including type 2 diabetes, obesity, sedentary lifestyle, and high glycemic load diet. Nut intake has been associated with a lower risk of type 2 diabetes, metabolic syndrome, and insulin resistance. However, the effect of nut intake on colon cancer recurrence and survival is not known. Patients and Methods We conducted a prospective, observational study of 826 eligible patients with stage III colon cancer who reported dietary intake on food frequency questionnaires while enrolled onto a randomized adjuvant chemotherapy trial. Using Cox proportional hazards regression, we assessed associations of nut intake with cancer recurrence and mortality. Results After a median follow-up of 6.5 years, compared with patients who abstained from nuts, individuals who consumed two or more servings of nuts per week experienced an adjusted hazard ratio (HR) for disease-free survival of 0.58 (95% CI, 0.37 to 0.92; Ptrend = .03) and an HR for overall survival of 0.43 (95% CI, 0.25 to 0.74; Ptrend = .01). In subgroup analysis, the apparent benefit was confined to tree nut intake (HR for disease-free survival, 0.54; 95% CI, 0.34 to 0.85; Ptrend = .04; and HR for overall survival, 0.47; 95% CI, 0.27 to 0.82; Ptrend = .04). The association of total nut intake with improved outcomes was maintained across other known or suspected risk factors for cancer recurrence and mortality. Conclusion Diets with a higher consumption of nuts may be associated with a significantly reduced incidence of cancer recurrence and death in patients with stage III colon cancer.
AB - Purpose Observational studies have reported increased colon cancer recurrence and mortality in patients with states of hyperinsulinemia, including type 2 diabetes, obesity, sedentary lifestyle, and high glycemic load diet. Nut intake has been associated with a lower risk of type 2 diabetes, metabolic syndrome, and insulin resistance. However, the effect of nut intake on colon cancer recurrence and survival is not known. Patients and Methods We conducted a prospective, observational study of 826 eligible patients with stage III colon cancer who reported dietary intake on food frequency questionnaires while enrolled onto a randomized adjuvant chemotherapy trial. Using Cox proportional hazards regression, we assessed associations of nut intake with cancer recurrence and mortality. Results After a median follow-up of 6.5 years, compared with patients who abstained from nuts, individuals who consumed two or more servings of nuts per week experienced an adjusted hazard ratio (HR) for disease-free survival of 0.58 (95% CI, 0.37 to 0.92; Ptrend = .03) and an HR for overall survival of 0.43 (95% CI, 0.25 to 0.74; Ptrend = .01). In subgroup analysis, the apparent benefit was confined to tree nut intake (HR for disease-free survival, 0.54; 95% CI, 0.34 to 0.85; Ptrend = .04; and HR for overall survival, 0.47; 95% CI, 0.27 to 0.82; Ptrend = .04). The association of total nut intake with improved outcomes was maintained across other known or suspected risk factors for cancer recurrence and mortality. Conclusion Diets with a higher consumption of nuts may be associated with a significantly reduced incidence of cancer recurrence and death in patients with stage III colon cancer.
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U2 - 10.1200/JCO.2017.75.5413
DO - 10.1200/JCO.2017.75.5413
M3 - Article
C2 - 29489429
AN - SCOPUS:85045056526
SN - 0732-183X
VL - 36
SP - 1112
EP - 1120
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
IS - 11
ER -
