Impact of genetic mutations and nutritional status on the survival of patients with colorectal cancer

Abstract

Background The prognosis of colorectal cancer (CRC) patients can be influenced by genetic mutations and nutritional status. The relationship between these variables is unclear. The objective of the study was to verify the variables involved in the nutritional status and genetic mutations, which correlate with survival of CRC patients. Methods Patients with surgical intervention for tumor resection were evaluated using body mass index, nutritional screening, patient self-produced global subjective assessment, phase angle, and computed tomography to calculate the areas of visceral adipose tissue (VAT) and subcutaneous adipose tissue, and muscle mass for the determination of sarcopenia. Ten gene mutations involved in CRC carcinogenesis were studied ( PIK3CA, KRAS, BRAF, EGFR, NRAS, TP53, APC, PTEN, SMAD4 , and FBXW7 ). DNA was extracted from fresh tumor or paraffin tissues. Results Of the 46 patients, 29 (64.4%) were at nutritional risk and 21 (45.7%) were moderately malnourished. However, there was a high percentage of VAT in 24 (61.5%) and sarcopenia in 19 (48.7%) patients. These variables were associated with a higher risk of mortality. Nutritional risk, moderate or severe malnutrition, phase angle < 5°, VAT < 163.8 cm 2 in men and < 80.1 cm 2 in women, and sarcopenia were associated with the relative risk of death, with respective hazard ratios/odds ratios and 95% confidence intervals of 8.77 (1.14–67.1), 3.95 (1.11–14.0), 3.79 (1.10–13.1), 3.43 (1.03–11.4), and 3.95 (1.06–14.6). Increased VAT was associated with a lower risk of death, even in patients older than 60 years or those harboring mutated KRAS . Conclusions Patients with positive indicators for malnutrition or risk of malnutrition had an increased risk of death. No relationship was identified between the presence of mutations and survival.

Prognostic utility of a geriatric nutritional risk index in combination with a comorbidity index in elderly patients with diffuse large B cell lymphoma

“…The CCI is a simple and widely used index for the assessment of comorbidities, but does not include malnutrition parameters that worsen the survival of cancer patients. 6,27 Not only serious comorbidities but also malnutrition was strongly associated with worse patient outcomes in elderly DLCBL patients. 6,8,10 We presumed that combining the GNRI with CCI, with each tool evaluating two independent parameters, comorbidities and malnutrition, could improve the prognostic accuracy over the CCI alone.…”

Malnutrition Accelerates Colorectal Cancer Progression through Macrophage Activated by B Cells Immune via Gut Microbiota

“…It increased the risk of tumor progression acceleration by reducing patient's response to anticancer treatment, which ultimately lowers the survival rate [4]. Malnourished patients with CRC including those treated with surgery, radiotherapy and/or chemotherapy, are at higher risks of suffering from postoperative complications, prolonged length of hospitalization causing heavy economic burden on family and society, a poorer quality of life, and an increased mortality [7][8][9]. The present study demonstrated that gut microbiota could be an important factor to recruit B cells and macrophages, which further activate mucosal immunity to accelerate the progression in CRC patients with malnutrition.…”

<p>The Down-Regulation of lncRNA PCAT18 Promotes the Progression of Gastric Cancer via MiR-107/PTEN/PI3K/AKT Signaling Pathway</p>

“…28,29 PIK3CA and PTEN mutations are common events in genetic mutations in cancer progression. [30][31][32] Previous study indicates that PIK3CA mutations are closely associated with survival time of patients with glioblastoma. 32 PTEN loss is associated with resistance to trastuzumab-based therapy.…”