title: Diabetes and Body Mass Index Are Associated with Neuropathy and Prognosis in Colon Cancer Patients Treated with Capecitabine and Oxaliplatin Adjuvant Chemotherapy.
abstract: BACKGROUND
  There are few background data on the impact of clinical factors on neurotoxicity and prognosis in patients treated with adjuvant capecitabine and oxaliplatin (CAPOX) chemotherapy.
  
  
  METHODS
  102 stage II high-risk and stage III colorectal cancer patients were treated for 6 months with adjuvant CAPOX, then they were followed up. Associations between clinical variables, metabolic syndrome components, smoking and neurotoxicity were evaluated by the x03C7;2 test. The Kaplan-Meier product limit method was applied to graph disease-free survival (DFS). Univariate analysis was done with the log-rank test. Cox's proportional hazards regression was used to analyze the effect of several risk factors on DFS.
  
  
  RESULTS
  Significant associations were found between diabetes (p < 0.001), BMI (p = 0.01) and the occurrence of chronic neurotoxicity. After a median follow-up of 46 months, 14 patients (13.7%) had suffered recurrence. An analysis of the prognostic factors for DFS showed that prognosis is unfavorable for patients with high lymph-nodal involvement (HR: 5.23, p = 0.0007), diabetes (HR: 4.86; p = 0.03) and a BMI ≥25 (HR: 3.69, p = 0.002).
  
  
  CONCLUSIONS
  Common mediators in diabetes and obesity could be involved in peripheral neuropathy and in stimulating micro-metastases. Further studies are necessary to explain this interesting connection between diabetes, obesity and colon cancer.
authors.affiliation: Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS - Fondazione G. Pascale, Naples, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Ottaiano
authors.forename: Anna
authors.initials: A
authors.lastname: Nappi
authors.forename: Salvatore
authors.initials: S
authors.lastname: Tafuto
authors.forename: Guglielmo
authors.initials: G
authors.lastname: Nasti
authors.forename: Chiara
authors.initials: C
authors.lastname: De Divitiis
authors.forename: Carmela
authors.initials: C
authors.lastname: Romano
authors.forename: Antonino
authors.initials: A
authors.lastname: Cassata
authors.forename: Rossana
authors.initials: R
authors.lastname: Casaretti
authors.forename: Lucrezia
authors.initials: L
authors.lastname: Silvestro
authors.forename: Antonio
authors.initials: A
authors.lastname: Avallone
authors.forename: Maurizio
authors.initials: M
authors.lastname: Capuozzo
authors.forename: Monica
authors.initials: M
authors.lastname: Capozzi
authors.forename: Piera
authors.initials: P
authors.lastname: Maiolino
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Quagliariello
authors.forename: Stefania
authors.initials: S
authors.lastname: Scala
authors.forename: Vincenzo Rosario
authors.initials: VR
authors.lastname: Iaffaioli
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D015992:Body Mass Index; D000069287:Capecitabine / Q000008:administration & dosage; D017024:Chemotherapy, Adjuvant; D002908:Chronic Disease; D003110:Colonic Neoplasms / Q000188:drug therapy*; D048909:Diabetes Complications / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy; D009765:Obesity / Q000150:complications*; D009944:Organoplatinum Compounds / Q000008:administration & dosage; D000077150:Oxaliplatin; D010523:Peripheral Nervous System Diseases / Q000175:diagnosis / Q000209:etiology*; D011379:Prognosis
chemical_list: D009944:Organoplatinum Compounds; D000077150:Oxaliplatin; D000069287:Capecitabine