The effect of smoking, obesity and diabetes on recurrence‐free and overall survival in patients with stage III colon cancer receiving adjuvant chemotherapy

Abstract

Background The association between smoking, diabetes and obesity and oncological outcomes in patients with stage III colon cancer treated with surgery and adjuvant chemotherapy is unclear. Aim To evaluate whether smoking, obesity and diabetes are associated with the disease‐free survival and overall survival rates of patients with stage III colon cancer who have received adjuvant chemotherapy. Methods Patients were selected from the prospectively maintained Australian Cancer Outcomes and Research Database (ACCORD). All stage III colon cancer patients who received adjuvant chemotherapy between January 2003 to December 2015 were retrospectively analyzed. The three primary exposures of interest were smoking status, body mass index (BMI) and diabetic (DM) status. The primary outcomes of interest were disease‐free survival (DFS) and overall survival (OS). Results A total of 785 patients between 2003 and 2015 were included for analysis. Using Kaplan‐Meier survivorship curves, there was no association between OS and smoking (P = .71), BMI (P = .3) or DM (P = .72). Similarly, DFS did not reveal an association with smoking (P = .34), BMI (P = .2) and DM (P = .34). Controlling for other covariates the results did not reach statistical significance in adjusted multiple regression models. Conclusion Smoking, obesity and DM were not shown to influence DFS or OS for patients with stage III colon cancer who have received adjuvant chemotherapy.

A systematic review and meta-analysis assessing the impact of body mass index on long-term survival outcomes after surgery for colorectal cancer

“…Obesity can be seen as a protective feature as fat stores can be mobilised to provide energy during catabolic states such as surgery, chemotherapy and radiotherapy [95]. Therefore, studies have demonstrated better or comparable colorectal cancer survival outcomes in obese patients with more advanced diseases [37,38]. It can be hypothesised that the protective influence of being overweight with a BMI of 25e30 in our study may be due to an enhanced nutritional reserve without the well-known detrimental features of obesity.…”

Oral cavity and oropharyngeal carcinoma disparities in age and survival in Indigenous and non-Indigenous populations of Queensland

“…In addition, Indigenous Australians aged 15 and over were 1.5 times as likely to be obese compared to non-Indigenous Australians [ 6 ]. Both smoking and obesity are independent risk factors for cancer development [ 10 , 11 ]. Besides these lifestyle habits, Indigenous Australians also tended to live in remote communities [ 9 , 12 ], therefore restricting their access to healthcare.…”

Post‐diagnosis adiposity and colorectal cancer prognosis: A Global Cancer Update Programme (CUP Global) systematic literature review and meta‐analysis

“…A total of 96 studies (53 publications) were on BMI and all-cause mortality, 10,[30][31][32][33][34][35][36]41,42,[238][239][240][241][242][243][244]246,252,253,255,257,259,261,263,[265][266][267][268][269][270]274,[276][277][278][279][280][282][283][284][285]287,290,292,295,296,299,300,302,303,307,30...…”

“…All included studies were observational, and no relevant RCTs were identified. Geographically, 24 publications were from Europe, 10,33,35,42,243,253,266,268,272,[276][277][278][279]282,284,291,293,[296][297][298]303,308,310,311 20 from North America, 30 19 from East or Southeast Asia, 36,239,241,246,247,251,252,256,258,262,264,269,280,290,294,295,302,305,307 four from Australia/New Zealand, 242,255,299,300 and 18 from mixed geographic locations 248,257,…”