Impact of Weight Changes After the Diagnosis of Stage III Colon Cancer on Survival Outcomes.
BACKGROUND
Weight modification after a diagnosis of colon cancer and its impact on outcomes remain unclear. Thus we aimed to examine the association of obesity and weight changes from baseline oncology consultation with recurrence-free survival (RFS) and overall survival (OS) in patients with stage III colon cancer.


METHODS
Patients aged ≥ 18 years who were diagnosed with stage III colon cancer in British Columbia from 2008 to 2010 and who received adjuvant chemotherapy were included in the study. Cox proportional hazards regression models were fitted to evaluate the impact of different body compositions and degree of weight changes from baseline assessment with outcomes while controlling for potentially confounding covariates, such as age and sex.


RESULTS
A total of 539 patients with stage III colon cancer were included: median age was 69 years (range, 26-94 years), 52% were men, and 53% had Eastern Cooperative Oncology Group (ECOG) performance status of 0-1. Those with weight gains of ≥ 10% had a median RFS of 37 months compared with 49 months in those with weight gains of < 10% (hazard ratio [HR], 0.94; 95% confidence interval [CI], 0.56-1.59; P = .82). However, this finding was not significant. In Cox models, patients who exhibited weight losses of ≥ 10% experienced significantly inferior RFS (HR, 3.45; 95% CI, 1.44-8.13; P = .0046) and OS (HR, 2.63; 95% CI, 1.04-6.67; P = .041) compared with those who experienced weight losses of < 10%. Weight gains, losses, or changes of equal or less magnitude did not show any significant associations with outcomes (all P > .05).


CONCLUSIONS
Weight losses of ≥ 10% from baseline evaluation bodes a worse prognosis among patients with stage III colon cancer.
Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Joanna
J
Vergidis
Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Gillian
G
Gresham
Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Howard J
HJ
Lim
Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Daniel J
DJ
Renouf
Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Hagen F
HF
Kennecke
Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Jenny Y
JY
Ruan
Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Jennifer T
JT
Chang
Division of Medical Oncology, University of British Columbia, British Columbia Cancer Agency, Vancouver, British Columbia, Canada. Electronic address: wcheung@bccancer.bc.ca.
Winson Y
WY
Cheung
D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001955:British Columbia; D003110:Colonic Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D015430:Weight Gain; D015431:Weight Loss
Obesity; Prognosis; Survival; Weight gain; Weight loss