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

Cybulska-Stopa, Bożena; Ługowska, Iwona; Wiśniowski, Rafał; Domagała-Haduch, Małgorzata; Rajczykowski, Marcin; Piejko, Karolina; Bar-Letkiewicz, Ilona; Suwiński, Rafał; Regulski, K.; Mackiewicz, Jacek

doi:10.5114/wo.2020.94728

Cited by 8 publications

(9 citation statements)

References 33 publications

(53 reference statements)

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“…There were 38 studies 43,45,46,59‐91,211,212 (40 cohorts; 2,361,275 participants) of cancer populations (Table S3); 17 cohorts were in East Asia, 10 cohorts in North America, 7 in Europe, 2 were international cohorts, 2 were in West Asia, and 1 each in South America and Africa. Mean age of participants ranged from 17 to 75 years.…”

Section: Resultsmentioning

confidence: 99%

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

2023

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SummaryFasting insulin and c‐reactive protein confound the association between mortality and body mass index. An increase in fat mass may mediate the associations between hyperinsulinemia, hyperinflammation, and mortality. The objective of this study was to describe the “average” associations between body mass index and the risk of mortality and to explore how adjusting for fasting insulin and markers of inflammation might modify the association of BMI with mortality. MEDLINE and EMBASE were searched for studies published in 2020. Studies with adult participants where BMI and vital status was assessed were included. BMI was required to be categorized into groups or parametrized as non‐first order polynomials or splines. All‐cause mortality was regressed against mean BMI squared within seven broad clinical populations. Study was modeled as a random intercept. β coefficients and 95% confidence intervals are reported along with estimates of mortality risk by BMIs of 20, 30, and 40 kg/m2. Bubble plots with regression lines are drawn, showing the associations between mortality and BMI. Splines results were summarized. There were 154 included studies with 6,685,979 participants. Only five (3.2%) studies adjusted for a marker of inflammation, and no studies adjusted for fasting insulin. There were significant associations between higher BMIs and lower mortality risk in cardiovascular (unadjusted β −0.829 [95% CI −1.313, −0.345] and adjusted β −0.746 [95% CI −1.471, −0.021]), Covid‐19 (unadjusted β −0.333 [95% CI −0.650, −0.015]), critically ill (adjusted β −0.550 [95% CI −1.091, −0.010]), and surgical (unadjusted β −0.415 [95% CI −0.824, −0.006]) populations. The associations for general, cancer, and non‐communicable disease populations were not significant. Heterogeneity was very large (I2 ≥ 97%). The role of obesity as a driver of excess mortality should be critically re‐examined, in parallel with increased efforts to determine the harms of hyperinsulinemia and chronic inflammation.

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Section: Resultsmentioning

confidence: 99%

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

2023

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“…Similarly, a retrospective study of data from 237 patients with metastatic CRC treated with chemotherapy plus bevacizumab in second line from January 2014 to August 2018 in four reference oncological centres in Poland also suggested high BMI was independently associated with improvement in both progression‐free survival (HR: 1.79; 1.13–2.84, p = 0.015) and overall survival (HR: 1.83; 1.12–2.99, p = 0.047) 94 …”

Section: Obesity and Colorectal Cancermentioning

confidence: 97%

“…The risk of unreported bias in the published study, 94 e.g., over‐selection of included patients, may explain these inconsistent results. This association should be tested before adapting treatment guidelines for chemotherapies and targeted therapies based on a patient's BMI or visceral fat area.…”

Section: Obesity and Colorectal Cancermentioning

confidence: 99%

“…93 Similarly, a retrospective study of data from 237 patients with metastatic CRC treated with chemotherapy plus bevacizumab in second line from January 2014 to August 2018 in four reference oncological centres in Poland also suggested high BMI was independently associated with improvement in both progression-free survival (HR: 1.79; 1.13-2.84, p = 0.015) and overall survival (HR: 1.83; 1.12-2.99, p = 0.047). 94 The risk of unreported bias in the published study, 94 e.g., overselection of included patients, may explain these inconsistent results. This association should be tested before adapting treatment guidelines for chemotherapies and targeted therapies based on a patient's BMI or visceral fat area.…”

Section: Obesity and Response To Chemotherapy And/or Targeted Therapiesmentioning

confidence: 99%

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Review article: obesity and colorectal cancer

Bardou

Rouland

Martel

et al. 2022

Aliment Pharmacol Ther

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Summary Background Obesity is a growing global public health problem. More than half the European and North American population is overweight or obese. Colon and rectum cancers are still the second leading cause of cancer death worldwide, and epidemiological data support an association between obesity and colorectal cancers (CRCs). Aim To review the literature on CRC epidemiology in obese subjects, assessing the effects of obesity, including childhood or maternal obesity, on CRC, diagnosis, management, and prognosis, and discussing targeted prophylactic measures. Method We searched PubMed for obesity/overweight/metabolic syndrome and CRC. Other key words included ‘staging’, ‘screening’, ‘treatment’, ‘weight loss’, ‘bariatric surgery’ and ‘chemotherapy’. Results In Europe, about 11% of CRCs are attributed to overweight and obesity. Epidemiological data suggest that obesity is associated with a 30%–70% increased risk of colon cancer in men, the association being less consistent in women. Visceral fat or abdominal obesity seems to be of greater concern than subcutaneous fat obesity, and any 1 kg/m2 increase in body mass index confers more risk (hazard ratio 1.03). Obesity might increase the likelihood of recurrence or mortality of the primary cancer and may affect initial management, including accurate staging. The risk maybe confounded by different factors, including lower adherence to organised CRC screening programmes. It is unclear whether bariatric surgery helps reduce rectal cancer risk. Conclusions Despite a growing body of evidence linking obesity to CRC, many questions remain unanswered, including whether we should screen patients with obesity earlier or propose prophylactic bariatric surgery for certain patients with obesity.

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“…On the other hand, Citronberg’s study did not find an association between LBP and CRC, or any association with body mass index (BMI), saturated fat intake, dietary fat intake, cancer site, or cancer condition [ 12 ]. However, in Cybulska-Stopa’s study, a higher BMI is associated with a statistically significantly better prognosis in patients with CRC [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Lipopolysaccharide-binding protein as a risk factor for development of infectious and inflammatory postsurgical complications in colorectal cancer patients

Turgunov

Ogizbayeva

Akhmaltdinova

et al. 2021

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Aim of the study: In this pilot study lipopolysaccharide-binding protein (LBP) levels were assessed as a possible risk factor for development of systemic inflammatory response syndrome (SIRS) and infectious and inflammatory complications in colorectal cancer (CRC) patients after surgery. Material and methods: For LBP determination venous blood was taken 1 hour before the surgery and 72 hours after it. All patients were stratified by the presence or absence of acute bowel obstruction (ABO), SIRS and complications.Results: 36 patients with CRC participated in the study. The LBP level before surgery was 879.8 ± 221.8 ng/ml (interquartile range (IQR) 749.3-1028.8); on the 3 rd day it was 766.5 ± 159.4 ng/ml (IQR 669.5-847.6), which was a statistically significant decrease (p = 0.004). A decrease in LBP level by more than 280 ng/ml increases the probability of SIRS and complications in operated CRC patients (OR 6.6, 95% CI: 1.1-40.9 and OR 12.0, 95% CI: 1.8-80.4, respectively). In patients with ABO in the presence of SIRS, the LBP value decreased more than in those without SIRS (p = 0.046). Conclusions: This study demonstrated that the LBP level in the operated CRC patients tends to decrease on the 3 rd day after surgery. A bigger decrease in LBP level increases the probability of SIRS and postoperative infectious and inflammatory complications. Therefore, further studies with larger numbers of patients are required.

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

Cited by 8 publications

References 33 publications

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

Associations between body mass index and all‐cause mortality: A systematic review and meta‐analysis

Review article: obesity and colorectal cancer

Lipopolysaccharide-binding protein as a risk factor for development of infectious and inflammatory postsurgical complications in colorectal cancer patients

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