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, Daniel M. Atienza, Michael Messino, Hedy L. Kindler, Alan Venook, Shuji Ogino, Kimmie Ng, Kana Wu, Walter Willett, Edward Giovannucci, Jeffrey MeyerhardtYing Bao, Charles S. Fuchs*

*Corresponding author for this work

Research output: Contribution to journalArticle

18 Scopus citations

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

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ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Fadelu, T., Zhang, S., Niedzwiecki, D., Ye, X., Saltz, L. B., Mayer, R. J., Mowat, R. B., Whittom, R., Hantel, A., Benson, A. B., Atienza, D. M., Messino, M., Kindler, H. L., Venook, A., Ogino, S., Ng, K., Wu, K., Willett, W., Giovannucci, E., ... 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