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The Association Between Adiposity and Survival in Patients with Colorectal Cancer

  • Cancer (MF Leitzmann, Section Editor)
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Abstract

Multiple studies confirm the impact of obesity on high incidence of colorectal cancer (CRC). There is a common perception that adiposity and related metabolic dysfunctions result in worse prognosis and decreased survival among patients with a CRC diagnosis. Several epidemiologic studies confirm this observation, however the results are not always consistent, probably due to different techniques used for evaluating the degree of adiposity. Many authors suggest that the most adequate method for assessing this parameter is computer tomography of the abdomen which allows to precisely quantify the amount of adipose tissue. Excess adipose tissue is considered a metabolically active organ releasing numerous adipohormones and cytokines that stimulate chronic inflammation, insulin resistance and contribute to increased cell proliferation. However, adiposity biomarker expression are well-documented risk factors for CRC development, little is known about their prognostic value in this disease.

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References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance

  1. Ferlay J, Shin HR, Bray F, et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010;127(12):2893–917.

    Article  CAS  PubMed  Google Scholar 

  2. Ng M, Fleming T, Robinson M, et al. Global, regional, and national prevalence of overweight and obesity in children and adults during 1980–2013: a systematic analysis for the global burden of disease study 2013. Lancet. 2014;384(9945):766–81.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Renehan AG, Tyson M, Egger M, Heller RF, Zwahlen M. Body-mass index and incidence of cancer: a systematic review and meta-analysis of prospective observational studies. Lancet. 2008;371(9612):569–78.

    Article  PubMed  Google Scholar 

  4. Ning Y, Wang L, Giovannucci EL. A quantitative analysis of body mass index and colorectal cancer: findings from 56 observational studies. Obes Rev. 2010;11:19–30.

    Article  CAS  PubMed  Google Scholar 

  5. Moghaddam AA, Woodward M, Huxley R. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomarkers Prev. 2007;16:2533–47.

    Article  PubMed  Google Scholar 

  6. Nam SY, Kim BC, Han KS, et al. Abdominal visceral adipose tissue predicts risk of colorectal adenoma in both sexes. Clin Gastroenterol Hepatol. 2010;8:443–50.

    Article  PubMed  Google Scholar 

  7. Lee CS, Murphy DJ, McMahon C, et al. Visceral adiposity is a risk factor for poor prognosis in colorectal cancer patients receiving adjuvant chemotherapy. J Gastrointest Cancer. 2015;46(3):243–50. A recent retrospective study providing data on the negative impact of visceral adiposity on survival after colorectal cancer (CRC) diagnosis. Authors prove that visceral fat area measured on computer tomography scans correspond to poor prognosis in this disease. Presented results confirm that BMI is not an adequate method to evaluate the impact of adiposity on survival in CRC.

    Article  CAS  PubMed  Google Scholar 

  8. Malietzis G, Aziz O, Bagnall NM, et al. The role of body composition evaluation by computerized tomography in determining colorectal cancer treatment outcomes: a systematic review. Eur J Surg Oncol. 2015;41(2):186–96.

    Article  CAS  PubMed  Google Scholar 

  9. Gutierez DA, Puglisi MJ, Hasty AH. Impact of increased adipose tissue mass on inflammation, insulin resistance, and dyslipidemia. Curr Diab Rep. 2009;9(1):26–32.

    Article  Google Scholar 

  10. Calle EE, Kaaks R. Overweight, obesity and cancer: epidemiological evidence and proposed mechanisms. Nat Rev Cancer. 2004;4:579–91.

    Article  CAS  PubMed  Google Scholar 

  11. Arnaldez F, Helman L. Targeting the insulin growth factor receptor 1. Hematol Oncol Clin North Am. 2012;26(3):527–42.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Janiak A, Oset P, Talar-Wojnarowska R, Kumor A, Małecka-Panas E. Insulin, insulin-like growth factor 1 and insulin-like growth factor binding protein 3 serum concentrations in patients with adenomatous colon polyps. Prz Gastroenterol. 2013;8(5):308–14.

    PubMed  PubMed Central  Google Scholar 

  13. Harriss DJ, Atkinson G, Batterham A, George K, et al. Lifestyle factors and colorectal cancer risk : a systematic review and meta-analysis of associations with leisure-time physical activity. Color Dis. 2009;11(7):689–701.

    Article  CAS  Google Scholar 

  14. Protani M, Coory M, Martin JH. Effect of obesity on survival of women with breast cancer: systematic review and meta-analysis. Breast Cancer Res Treat. 2010;123(3):627–35.

    Article  PubMed  Google Scholar 

  15. Cao Y, Ma J. Body mass index, prostate cancer-specific mortality, and biochemical recurrence: a systematic review and meta-analysis. Cancer Prev Res (Phila). 2011;4(4):486–501.

    Article  CAS  Google Scholar 

  16. Parkin E, O’Reilly DA, Sherlock DJ, Manoharan P, Renehan AG. Excess adiposity and survival in patients with colorectal cancer: a systematic review. Obes Rev. 2014;15(5):434–51.

    Article  PubMed  Google Scholar 

  17. Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ. Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults. N Engl J Med. 2003;348(17):1625–38.

    Article  PubMed  Google Scholar 

  18. Demark-Wahnefried W, Platz EA, Ligibel JA, et al. The role of obesity in cancer survival and recurrence. Cancer Epidemiol Biomarkers Prev. 2012;21(8):1244–59.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Dignam JJ, Polite BN, Yothers G, et al. Body mass index and outcomes in patients who receive adjuvant chemotherapy for colon cancer. J Natl Cancer Inst. 2006;98(22):1647–54.

    Article  PubMed  Google Scholar 

  20. Meyerhardt JA, Niedzwiecki D, Hollis D, et al. Impact of body mass index and weight change after treatment on cancer recurrence and survival in patients with stage III colon cancer: findings from cancer and leukemia group B 89803. J Clin Oncol. 2008;26(25):4109–15.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Han TS, van Leer EM, Seidell JC, Lean ME. Waist circumference action levels in the identification of cardiovascular risk factors: prevalence study in a random sample. BMJ. 1995;311(7017):1401–5.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Carnethon MR, De Chavez PJ, Biggs ML, et al. Association of weight status with mortality in adults with incident diabetes. JAMA. 2012;308(6):581–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  23. Schoen RE, Tangen CM, Kuller LH, et al. Increased blood glucose and insulin, body size, and incident colorectal cancer. J Natl Cancer Inst. 1999;91(13):1147–54.

    Article  CAS  PubMed  Google Scholar 

  24. Haydon AM, Macinnis RJ, English DR, Giles GG. Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut. 2006;55(1):62–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Yoshizumi T, Nakamura T, Yamane M, et al. Abdominal fat: standardized technique for measurement at CT. Radiology. 1999;211(1):283–6.

    Article  CAS  PubMed  Google Scholar 

  26. Hunter GR, Snyder SW, Kekes-Szabo T, et al. Intra-abdominal adipose tissue values associated with risk of possessing elevated blood lipids and blood pressure. Obes Res. 1994;2(6):563–8.

    Article  CAS  PubMed  Google Scholar 

  27. Després JP, Lamarche B. Effects of diet and physical activity on adiposity and body fat distribution: implications for the prevention of cardiovascular disease. Nutr Res Rev. 1993;6(1):137–59.

    Article  PubMed  Google Scholar 

  28. Guiu B, Petit JM, Bonnetain F, et al. Visceral fat area is an independent predictive biomarker of outcome after first-line Bevacizumab-based treatment in metastatic colorectal cancer. Gut. 2010;59(3):341–7.

    Article  CAS  PubMed  Google Scholar 

  29. Cakir H, Heus C, Verduin WM. Visceral obesity, body mass index and risk of complications after colon cancer resection: a retrospective cohort study. Surgery. 2015;157(5):909–15. A retrospective study on large group of CRC patients who underwent surgical treatment. Authors provide data confirming the impact of adiposity evaluated by computer tomography (visceral fat area measurement - VFA) on complication rate after elective resection of CRC.

    Article  PubMed  Google Scholar 

  30. Watanabe J, Tatsumi K, Ota M, et al. The impact of visceral obesity on surgical outcomes of laparoscopic surgery for colon cancer. Int J Color Dis. 2014;29(3):343–51. A study on large group of patients who underwent laparoscopic resection of CRC. The authors showed that high BMI and high VFA are valuable predictive factors of postoperative complications incidence.

    Article  Google Scholar 

  31. Kang J, Baek SE, Kim T, et al. Impact of fat obesity on laparoscopic total mesorectal excision: more reliable indicator than body mass index. Int J Color Dis. 2012;27(4).

  32. Yamamoto N, Fujii S, Sato T, et al. Impact of body mass index and visceral adiposity on outcomes in colorectal cancer. Asia Pac J Clin Oncol. 2012;8(4):337–45.

    Article  PubMed  Google Scholar 

  33. Rickles AS, Iannuzzi JC, Mironov O, et al. Visceral obesity and colorectal cancer: are we missing the boat with BMI? J Gastrointest Surg. 2013;17(1):133–43.

    Article  PubMed  Google Scholar 

  34. Kaess BM, Pedley A, Massaro JM, et al. The ratio of visceral to subcutaneous fat, a metric of body fat distribution, is a unique correlate of cardiometabolic risk. Diabetologia. 2012;55(10):2622–30.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  35. Moon HG, Ju YT, Jeong CY, et al. Visceral obesity may affect oncologic outcome in patients with colorectal cancer. Ann Surg Oncol. 2008;15(7):1918–22.

    Article  PubMed  Google Scholar 

  36. Clark W, Siegel EM, Chen YA, et al. Quantitative measures of visceral adiposity and body mass index in predicting rectal cancer outcomes after neoadjuvant chemoradiation. J Am Coll Surg. 2013;216(6):1070–81.

    Article  PubMed  PubMed Central  Google Scholar 

  37. Meyerhardt JA, Catalano PJ, Haller DG, et al. Influence of body mass index on outcomes and treatment-related toxicity in patients with colon carcinoma. Cancer. 2003;98(3):484–95.

    Article  PubMed  Google Scholar 

  38. Prizment AE, Flood A, Anderson KE, Folsom AR. Survival of women with colon cancer in relation to precancer anthropometric characteristics: the Iowa Women’s health study. Cancer Epidemiol Biomarkers Prev. 2010;19(9):2229–37.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Aleksandrova K, Nimptsch K, Pischon T. Influence of obesity and related metabolic alterations on colorectal cancer risk. Curr Nutr Rep. 2013;2(1):1–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  40. Muc-Wierzgon M, Nowakowska-Zajdel E, Dziegielewska-Gesiak S. Specific metabolic biomarkers as risk and prognostic factors in colorectal cancer. World J Gastroenterol. 2014;20(29):9759–74.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Siddiqui AA, Spechler SJ, Huerta S, et al. Elevated HbA1c is an independent predictor of aggressive clinical behavior in patients with colorectal cancer: a case–control study. Dig Dis Sci. 2008;53(9):2486–94.

    Article  CAS  PubMed  Google Scholar 

  42. Miao Jonasson J, Cederholm J, Eliasson B, et al. HbA1C and cancer risk in patients with type 2 diabetes--a nationwide population-based prospective cohort study in Sweden. PLoS One. 2012;7(6), e38784.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Fuchs CS, Goldberg RM, Sargent DJ, et al. Plasma insulin-like growth factors, insulin-like binding protein-3, and outcome in metastatic colorectal cancer: results from intergroup trial N9741. Clin Cancer Res. 2008;14(24):8263–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  44. Liou JM, Shun CT, Liang JT, et al. Plasma insulin-like growth factor-binding protein-2 levels as diagnostic and prognostic biomarker of colorectal cancer. J Clin Endocrinol Metab. 2010;95(4):1717–25.

    Article  CAS  PubMed  Google Scholar 

  45. Stryjkowska-Gora A, Karczmarek-Borowska B, Gora T, Krawczak K. Statins and cancer. Contemp Oncol. 2015;19(3):167–75.

    Google Scholar 

  46. Nielsen SF, Nordestgaard BG, Bojesen SE. Statin use and reduced cancer-related mortality. N Engl J Med. 2013;368(6):576–7.

    CAS  PubMed  Google Scholar 

  47. Ng K, Ogino S, Meyerhardt JA, et al. Relationship between statin use and colon cancer recurrence and survival: results from CALGB 89803. J Natl Cancer Inst. 2011;103:1540–51.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  48. Mace AG, Gantt GA, Skacel M, Pai R, Hammel JP, Kalady MF. Statin therapy is associated with improved pathologic response to neoadjuvant chemoradiation in rectal cancer. Dis Colon Rectum. 2013;56:1217–27.

    Article  PubMed  Google Scholar 

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Acknowledgments

The study was financed by statutory funds from the Medical University of Lodz, Poland (503/1-002-01/503-11-002), funds from Medical University of Lodz, Poland for supporting young scientists (502-03/1-002-01/502-14-207) and funds from Polish Society of Prevention of Digestive Tract Diseases Neoplasms.

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  1. Department of Digestive Tract Diseases, Medical University of Lodz, Kopcinskiego 22, 90-153, Lodz, Poland

    Lukasz Durko & Ewa Malecka-Panas

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  1. Lukasz Durko
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Correspondence to Lukasz Durko.

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Lukasz Durko and Ewa Malecka-Panas declare that they have no conflict of interest.

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This article is part of the Topical Collection on Cancer

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Durko, L., Malecka-Panas, E. The Association Between Adiposity and Survival in Patients with Colorectal Cancer. Curr Nutr Rep 5, 48–53 (2016). https://doi.org/10.1007/s13668-016-0157-7

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