Nut consumption and survival in patients with stage III colon cancer

Results from CALGB 89803 (Alliance)

Temidayo Fadelu, Sui Zhang, Donna Niedzwiecki, Xing Ye, Leonard B. Saltz, Robert J. Mayer, Rex B. Mowat, Renaud Whittom, Alexander Hantel, Al B Benson III, Daniel M. Atienza, Michael Messino, Hedy L. Kindler, Alan Venook, Shuji Ogino, Kimmie Ng, Kana Wu, Walter Willett, Edward Giovannucci, Jeffrey Meyerhardt & 2 others Ying Bao, Charles S. Fuchs*

*Corresponding author for this work

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1112-1120
Number of pages9
JournalJournal of Clinical Oncology
Volume36
Issue number11
DOIs
StatePublished - Apr 10 2018

Fingerprint

Nuts
Colonic Neoplasms
Survival
Recurrence
Type 2 Diabetes Mellitus
Disease-Free Survival
Observational Studies
Mortality
Diet
Sedentary Lifestyle
Neoplasms
Hyperinsulinism
Adjuvant Chemotherapy
Insulin Resistance
Obesity
Eating
Prospective Studies
Incidence

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Fadelu, T., Zhang, S., Niedzwiecki, D., Ye, X., Saltz, L. B., Mayer, R. J., ... Fuchs, C. S. (2018). Nut consumption and survival in patients with stage III colon cancer: Results from CALGB 89803 (Alliance). Journal of Clinical Oncology, 36(11), 1112-1120. https://doi.org/10.1200/JCO.2017.75.5413
Fadelu, Temidayo ; Zhang, Sui ; Niedzwiecki, Donna ; Ye, Xing ; Saltz, Leonard B. ; Mayer, Robert J. ; Mowat, Rex B. ; Whittom, Renaud ; Hantel, Alexander ; Benson III, Al B ; Atienza, Daniel M. ; Messino, Michael ; Kindler, Hedy L. ; Venook, Alan ; Ogino, Shuji ; Ng, Kimmie ; Wu, Kana ; Willett, Walter ; Giovannucci, Edward ; Meyerhardt, Jeffrey ; Bao, Ying ; Fuchs, Charles S. / Nut consumption and survival in patients with stage III colon cancer : Results from CALGB 89803 (Alliance). In: Journal of Clinical Oncology. 2018 ; Vol. 36, No. 11. pp. 1112-1120.
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title = "Nut consumption and survival in patients with stage III colon cancer: Results from CALGB 89803 (Alliance)",
abstract = "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.",
author = "Temidayo Fadelu and Sui Zhang and Donna Niedzwiecki and Xing 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 Atienza, {Daniel M.} and Michael Messino and Kindler, {Hedy L.} and Alan Venook and Shuji Ogino and Kimmie Ng and Kana Wu and Walter Willett and Edward Giovannucci and Jeffrey Meyerhardt and Ying Bao and Fuchs, {Charles S.}",
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Fadelu, T, Zhang, S, Niedzwiecki, D, Ye, X, Saltz, LB, Mayer, RJ, Mowat, RB, Whittom, R, Hantel, A, Benson III, AB, Atienza, DM, Messino, M, Kindler, HL, Venook, A, Ogino, S, Ng, K, Wu, K, Willett, W, Giovannucci, E, Meyerhardt, J, Bao, Y & Fuchs, CS 2018, 'Nut consumption and survival in patients with stage III colon cancer: Results from CALGB 89803 (Alliance)', Journal of Clinical Oncology, vol. 36, no. 11, pp. 1112-1120. https://doi.org/10.1200/JCO.2017.75.5413

Nut consumption and survival in patients with stage III colon cancer : Results from CALGB 89803 (Alliance). / Fadelu, Temidayo; Zhang, Sui; Niedzwiecki, Donna; Ye, Xing; Saltz, Leonard B.; Mayer, Robert J.; Mowat, Rex B.; Whittom, Renaud; Hantel, Alexander; Benson III, Al B; Atienza, Daniel M.; Messino, Michael; Kindler, Hedy L.; Venook, Alan; Ogino, Shuji; Ng, Kimmie; Wu, Kana; Willett, Walter; Giovannucci, Edward; Meyerhardt, Jeffrey; Bao, Ying; Fuchs, Charles S.

In: Journal of Clinical Oncology, Vol. 36, No. 11, 10.04.2018, p. 1112-1120.

Research output: Contribution to journalArticle

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 III, 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.

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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SP - 1112

EP - 1120

JO - Journal of Clinical Oncology

JF - Journal of Clinical Oncology

SN - 0732-183X

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