The impact of body mass index and nuclear β-catenin on survival in locally advanced rectal cancer treated with preoperative radiochemotherapy.
OBJECTIVE
We examined the prognostic value of obesity and nuclear β-catenin in patients with locally advanced rectal cancer.


METHODS
We prospectively recruited a total of 98 eligible patients with locally advanced cancer for preoperative radiochemotherapy followed by total mesorectal excision. Patients' height and weight were reaorded before radiochemotherapy, and the immunohistochemical expression of nuclear β-catenin was analyzed. Disease-free survival (DFS) was analyzed using the Kaplan-Meier method and a Cox regression model was employed for the multivariate analysis.


RESULTS
Obese patients were associated with a lower number of recurrences (3.6% vs. 34.3%, P = 0.001), and a higher DFS (95% vs. 53%; HR, 0.09; 95%CI, 0.01-0.64; P = 0.005) than non-obese patients. In the multivariate analysis, body mass index, nuclear β-catenin expression, and the absence of lymph node metastases showed a significant increase in DFS.


CONCLUSIONS
Obesity and nuclear β-catenin are independent favorable prognostic factors for DFS in locally advanced cancer treated with preoperative radiochemotherapy. J. Surg. Oncol. 2017;115:301-306. © 2017 Wiley Periodicals, Inc.
Department of Radiation Oncology, University Hospital Virgen de la Victoria, Málaga, Spain.
Jaime
J
Gomez-Millan
Department of Endocrinology, Biomedical Research Institute (IBIMA), Málaga, Spain.
Maria Isabel
MI
Queipo
Department of Radiation Oncology, University Hospital Juan Ramón Jiménez, Huelva, Spain.
Maria
M
Del Mar Delgado
Department of Pathology, University Hospital Virgen de la Victoria, Málaga, Spain.
Lidia
L
Perez-Villa
Department of Radiation Oncology, University Hospital Virgen de la Victoria, Málaga, Spain.
Alicia
A
Roman
Department of Surgery, Colorectal Surgery, University Hospital Virgen del Rocío, Seville, Spain.
Fernando
F
De la Portilla
Department of Medical Oncology, University Hospital Virgen de la Victoria, Málaga, Spain.
Esperanza
E
Torres
Department of Medical Oncology, University Hospital Virgen de la Victoria, Málaga, Spain.
Vanessa
V
De Luque
Department of Radiation Oncology, University Hospital Juan Ramón Jiménez, Huelva, Spain.
Eloisa
E
Bayo
Department of Radiation Oncology, University Hospital Virgen de la Victoria, Málaga, Spain.
Jose Antonio
JA
Medina
D015992:Body Mass Index; D002467:Cell Nucleus / Q000378:metabolism; D059186:Chemoradiotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000473:pathology; D009367:Neoplasm Staging; D009765:Obesity / Q000378:metabolism / Q000473:pathology*; D011300:Preoperative Care / Q000379:methods; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000378:metabolism / Q000473:pathology* / Q000601:surgery / Q000628:therapy*; D051176:beta Catenin / Q000096:biosynthesis*
C495270:CTNNB1 protein, human; D051176:beta Catenin
body mass index; preoperative radiochemotherapy; rectal neoplasm