Grain Intake and Clinical Outcome in Stage III Colon Cancer: Results From CALGB 89803 (Alliance)

被引：14

作者：

Brown, Justin C. ^{[1
]}

Zhang, Sui ^{[1
]}

Niedzwiecki, Donna ^{[2
]}

Saltz, Leonard B. ^{[3
]}

Mayer, Robert J. ^{[1
]}

Mowat, Rex B. ^{[4
]}

Whittom, Renaud ^{[5
]}

Hantel, Alexander ^{[6
]}

Benson, Al ^{[7
]}

Atienza, Daniel ^{[8
]}

Messino, Michael ^{[9
]}

Kindler, Hedy ^{[10
]}

Venook, Alan ^{[11
]}

Ogino, Shuji ^{[1
,12
,13
]}

Li, Yanping ^{[12
]}

Zhang, Xuehong ^{[13
]}

Ng, Kimmie ^{[1
]}

Willett, Walter C. ^{[12
]}

Giovannucci, Edward L. ^{[12
,13
]}

Fuchs, Charles S. ^{[14
]}

Meyerhardt, Jeffrey A. ^{[1
]}

机构：

[1] Dana Farber Partners CancerCare, Boston, MA USA

[2] Duke Univ, Med Ctr, Duke Canc Inst, Durham, NC USA

[3] Mem Sloan Kettering Canc Ctr, 1275 York Ave, New York, NY 10021 USA

[4] Toledo Community Hosp, Oncol Program, Toledo, OH USA

[5] Hop Sacre Coeur Montreal, Montreal, PQ, Canada

[6] Edward Elmhurst Heatlhcare, Naperville, IL USA

[7] Northwestern Univ, Robert H Lurie Comprehens Canc Ctr, Chicago, IL 60611 USA

[8] Virginia Oncol Associates, Norfolk, VA USA

[9] Mission Hosp Inc, Southeast Clin Oncol Res SCOR Consortium, Asheville, NC USA

[10] Univ Chicago, Comprehens Canc, Chicago, IL 60637 USA

[11] Univ Calif San Francisco, Comprehens Canc Ctr, San Francisco, CA 94143 USA

[12] Harvard TH Chan Sch Publ Hlth, Boston, MA USA

[13] Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA

[14] Yale Sch Med, Yale Canc Ctr, New Haven, CT USA

来源：

JNCI CANCER SPECTRUM | 2018年 / 2卷 / 02期

基金：

美国国家卫生研究院;

关键词：

D O I：

10.1093/jncics/pky017

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Background: Energy balance-related risk factors for colon cancer recurrence and mortality-type II diabetes, hyperinsulinemia, inflammation, and visceral obesity-are positively correlated with consumption of refined grains and negatively correlated with consumption of whole grains. We examined the relationship between the consumption of refined and whole grains with cancer recurrence and mortality in a cohort of patients with colon cancer. Methods: We conducted a prospective observational study of 1024 patients with stage III colon cancer who participated in a randomized trial of postoperative chemotherapy. Patients reported consumption of refined and whole grains using a food frequency questionnaire during and six months after chemotherapy. The primary outcome was disease-free survival (DFS). Multivariable-adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression models. All P values are two-sided. Results: During a median follow-up of 7.3 years, 394 patients experienced a DFS event. The hazard ratio for DFS was 1.56 (95% CI = 1.09 to 2.24) for patients consuming three or more servings per day of refined grains compared with patients consuming less than one serving per day (P-trend = .005). The hazard ratio for DFS was 0.89 (95% CI = 0.66 to 1.20) for patients consuming three or more servings per day of whole grains compared with patients consuming less than one serving per day (P-trend = .54). The hazard ratio for DFS of substituting one serving per day of refined grain with one serving per day of whole grain was 0.87 (95% CI = 0.79 to 0.96, P = .007). Conclusions: The choice of grain consumed may be associated with cancer recurrence and mortality. Future studies are necessary to confirm our findings and to inform the design of randomized trials.

引用

页数：8

共 42 条

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