Is obesity an advantage in patients with colorectal cancer?

Kasi, Pashtoon Murtaza; Zafar, S. Yousuf; Grothey, Axel

doi:10.1586/17474124.2015.1089170

Cited by 27 publications

(24 citation statements)

References 34 publications

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“…The connection between obesity and colorectal cancer is well established, 44 , 45 and a great deal of supporting evidence from clinical and epidemiological data has suggested that this connection is probably mediated by abnormal adiponectin in circulation. 46 Adiponectin is the most abundant hormone secreted by adipose tissue, and its anti-inflammatory and insulin-sensitizing properties may, at least in part, expound on the etiologic link between obesity and colorectal cancer.…”

Section: Discussionmentioning

confidence: 99%

Low circulating total adiponectin, especially its non-high-molecular weight fraction, represents a promising risk factor for colorectal cancer: a meta-analysis

Lü¹,

Huang²,

Li³

et al. 2018

OTT

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AimThe principal goal of this meta-analysis is to test the hypothesis that circulating total adiponectin or certain fractions may represent a promising biological candidate in modulating the risk of colorectal cancer.MethodsThe processes of paper identification, paper selection and data extraction were accomplished independently by two authors. Effect-size estimates were expressed as weighted mean difference (WMD) and 95% confidence interval (95% CI). A total of 31 papers including 48 qualified studies (7,554 patients with colorectal cancer and 9,798 controls) were meta-analyzed.ResultsPooling all studies found that circulating total adiponectin was significantly lower in patients with colorectal cancer than in controls (WMD: −0.76 µg/mL, 95% CI: −1.20 to −0.32, p=0.001), with significant heterogeneity (I2: 94.2%) and low publication bias (Egger’s p=0.336). By adiponectin fractions, the difference in high-molecular weight (HMW) adiponectin was comparable between the two groups (WMD: −0.22 µg/mL, 95% CI: −0.70 to 0.25, p=0.350), while non-HMW adiponectin was significantly lower in patients with colorectal cancer than in controls (WMD: −0.27 µg/mL, 95% CI: −0.35 to −0.19, p<0.001), with marginal heterogeneity (I2: 52.3%). Subgroup analysis revealed that effect-size estimates were heterogeneous when grouping studies by cancer subtype, region, study design, matching status, gender and obesity. Further meta-regression analysis indicated that age and gender were significant potential sources of heterogeneity. The results showed the studied subgroups were not subject to publication bias (Egger’s p<0.1).ConclusionOur data collectively indicate that low circulating total adiponectin, especially its non-HMW fraction, represents a promising risk factor for colorectal cancer. Further studies are needed to explore underlying mechanisms.

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Section: Discussionmentioning

confidence: 99%

Low circulating total adiponectin, especially its non-high-molecular weight fraction, represents a promising risk factor for colorectal cancer: a meta-analysis

Lü¹,

Huang²,

Li³

et al. 2018

OTT

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“…The prognostic effect of BMI is beginning to be well understood in the early stages of colon cancer, for which both underweight and obese patients have increased risk for progression or death [22,23]. However, to date, the prognostic and predictive relationships between patients BMI and patient outcomes have been poorly understood in the metastatic setting [4]. It may affect the efficacy of bevacizumab in the treatment of obese patients with mCRC.…”

Section: Discussionmentioning

confidence: 99%

“…Obesity is a known factor associated with death [1] and is a well-known carcinogenic factor for colorectal cancer [2][3][4]. Obesity can cause production of vascular endothelial growth factor (VEGF), angiopoietin-2, and other growth factors that induce tumor growth [5,6].…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies showed that BMI was associated with prognosis in early-stage CRC, specially low BMI was associated with worse prognosis in metastatic CRC (mCRC) [4]. Other studies have shown that overweight and obesity may be a negative prognostic factor in patients with mCRC and bevacizumab may be less effective in obese mCRC patients [14].…”

Section: Introductionmentioning

confidence: 99%

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Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy

Cybulska-Stopa¹,

Ługowska²,

Wiśniowski³

et al. 2020

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Introduction: Previous studies showed that high and low body mass index (BMI) was associated with worse prognosis in metastatic CRC (mCRC). Whether BMI is a prognostic or predictive factor in mCRC is unclear. We aimed to assess efficacy outcomes according to BMI in patient with metastatic colorectal cancer treated with bevacizumab plus FOLFOX chemotherapy regimen in second-line treatment. Material and methods: The analysis of 237 patients with metastatic colorectal cancer treated with bevacizumab plus FOLFOX in the second line (treated from January 2014 to August 2018) in 4 reference oncological centers in Poland. Results: The median age of the patients was 65 years (range 34-82). The median overall survival (OS) and progression-free survival (PFS) of the all 237 patient was 14.6 and 8.8 months, respectively. Comparison of obese patient (BMI > 30 kg/m 2) vs. overweight patients (BMI ≥ 25 to < 30 kg/m 2) vs. normal BMI range patients revealed a significant improvement of median OS (17.5 vs. 14.3 vs. 13.1 months, p = 0.01) and median PFS (9.4 vs. 9.1 vs. 7.3 months, p = 0.03). The Cox hazard model showed that the BMI class is an important risk factor. However, the Cox model also showed that the significance of the BMI class applies only to patients with BMI < 25 kg/m 2. This rule applies to both OS and PFS. The regression analysis also confirmed that there is a statistically significant relationship between the length of OS and PFS and the BMI value. Higher BMI was associated with a better prognosis. There were no differences in responses to treatment bevacizumab and FOLFOX chemotherapy and number adverse events according to BMI values. Conclusions: Patients with mCRC treated with chemotherapy with bevacizumab in second-line treatment with higher BMI compared with normal weight patients have better prognosis in terms of PFS and OS. In this group, we found no evidence of changes in safety profile depending on BMI. Nevertheless, further large randomized studies are needed to assess the body weight on the effectiveness of chemotherapy in combination with bevacizumab.

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“…This study is presented at the World Congress on Gastrointestinal Cancer 2015. This observation concerning the relationship between worse outcome and the lowest BMI does not mean that obesity is an advantage in patients with mCRC [150]. Probably, in patients with mCRC with a lower BMI, the effects of cancer-related cachexia may be more deleterious.…”

Section: In Metastatic Diseasementioning

confidence: 99%

Body Mass Index and Colorectal Cancer

Aykan¹,

Artaç²,

Özatlı³

2019

Body-Mass Index and Health

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Colorectal cancer (CRC) is one of the most common cancers in the world. Obesity is an established risk factor for colorectal carcinogenesis. Many epidemiological and experimental studies support this link and tumor-promoting effects of obesity. Body mass index (BMI) is a marker of general obesity. Obesity is also a global health problem and is defined by World Health Organization as BMI > 30 kg/m 2. In this chapter, we give a general review about the mechanisms of obesity on colorectal carcinogenesis and the effects of obesity on clinical outcomes such as disease-free survival (DFS), progression-free survival (PFS) and overall survival (OS), in adjuvant setting and metastatic disease, respectively.

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Is obesity an advantage in patients with colorectal cancer?

Cited by 27 publications

References 34 publications

Low circulating total adiponectin, especially its non-high-molecular weight fraction, represents a promising risk factor for colorectal cancer: a meta-analysis

Low circulating total adiponectin, especially its non-high-molecular weight fraction, represents a promising risk factor for colorectal cancer: a meta-analysis

Overweight is associated with better prognosis in metastatic colorectal cancer patients treated with bevacizumab plus FOLFOX chemotherapy

Body Mass Index and Colorectal Cancer

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