Fruit and vegetable intake and the risk of recurrence in patients with non-muscle invasive bladder cancer: a prospective cohort study

Abstract

IntroductionThere is some evidence that greater consumption of fruit and vegetables decreases the risk of bladder cancer. The role of fruit and vegetables in bladder cancer recurrence is still unknown.ObjectiveThe role of total fruit and vegetable intake in relation to the risk of developing bladder cancer recurrence in a prospective cohort study.Methods728 patients with non-muscle invasive bladder cancer (NMIBC), who completed self-administrated questionnaires on fruit and vegetable intake at time of diagnosis (over the year before diagnosis) and 1 year after diagnosis, were included. Hazard ratios and 95% confidence intervals were calculated by multivariable Cox regression for developing recurrent bladder cancer in relation to fruit and vegetable intake.ResultsDuring 2,051 person-years of follow-up [mean (SD) follow-up 3.7 (1.5) years], 241 (33.1%) of the included 728 NMIBC patients developed a recurrence of bladder cancer. The sum of total fruit and vegetables before diagnosis was not related to a first bladder cancer recurrence (HR 1.07; 95% CI 0.78–1.47, p = 0.66). No association was found between greater consumption of fruit and vegetables over the year before diagnosis and the risk of developing multiple recurrences of bladder cancer (HR 1.02; 95% CI 0.90–1.15, p = 0.78). Among the remaining 389 NMIBC patients who reported on fruit and vegetable intake 1 year after diagnosis, no association was found between greater consumption of fruit and vegetables and a first recurrence of bladder cancer (HR 0.65; 95% CI 0.42–1.01, p = 0.06) nor with multiple recurrences of bladder cancer (HR 1.00, 95% CI 0.85–1.18, p = 1.00). Similar results were obtained when investigating the association between total intakes of fruit and vegetables separately and bladder cancer recurrence.ConclusionResults from this study did not indicate a protective role for total fruit and vegetables in the development of a recurrence of NMIBC.Electronic supplementary materialThe online version of this article (10.1007/s10552-018-1029-9) contains supplementary material, which is available to authorized users.

Vegetable and Fruit Consumption and Prognosis Among Cancer Survivors: A Systematic Review and Meta-Analysis of Cohort Studies

“…In 2 studies on bladder cancer patients, the pre- and postdiagnosis intake of total vegetables, fruit, or both were not related to either all-cause mortality or cancer recurrence ( 38 , 51 ). No association with the consumption of cruciferous vegetables before diagnosis was found either ( 38 ).…”

“…Finally, a total of 28 articles were included in the systematic review and meta-analysis ( Figure 1 ). Of these, 16 studies were used for the qualitative review ( 36 – 51 ) and 12 for the quantitative meta-analysis ( 52 – 63 ).…”

“…Vegetable and fruit consumption was not associated with prognosis in bladder cancer ( 38 , 51 ). The WCRF/AICR report shows that the risk of bladder cancer is inversely related to the intake of nonstarchy vegetables and fruit, although with limited evidence ( 65 ).…”

The Facts about Food after Cancer Diagnosis: A Systematic Review of Prospective Cohort Studies

“…Many “cancer diets” are often restrictive, avoiding a whole nutrient class (i.e., meat or dairy products) in the misleading belief that certain foods “feed the tumor” [ 10 ]. In the last decades, a growing number of prospective cohort studies [ 11 , 12 , 13 , 14 , 15 , 16 ] have investigated the association between post-diagnostic dietary patterns—such as Western diet (WD) and prudent diet (PD)—or food type—such as meat, dairy products, dietary fiber, nuts—and prognostic outcomes among patients with different cancers. This systematic review aims to investigate possible associations between dietary patterns/choices after cancer diagnosis and prognostic outcomes (i.e., mortality, cancer progression, and recurrence) in patients affected by main solid tumors.…”

Lifestyle and Non-muscle Invasive Bladder Cancer Recurrence, Progression, and Mortality: Available Research and Future Directions

“…An intake of ≥ 1 serving of uncooked broccoli/month (mean 3.9 servings/month) was associated with a reduced risk of CSM (HR 0.43, 95% CI 0.25-0.74) and ACM (HR 0.57, 95% CI 0.39-0.83) compared to an intake of < 1 serving/month. This and two other studies reported no associations between fruit and/or vegetable consumption and recurrence, [94,96] progression, [96] or mortality [95]. Another study reported that heavy areca nut chewing (>10 nuts/day), a practice common among individuals in South Asia, may be associated with an increased risk of recurrence (HR 2.18, 95% CI 1.37-3.47) compared to non-chewing [29].…”