Weight parameters impact mortality in colorectal cancer
SAN ANTONIO — Obesity and underweight were associated with worse colorectal cancer outcomes, recurrence and mortality, compared with normal weight, according to results of a meta-analysis presented at the American College of Gastroenterology Annual Meeting.
“Obesity is thought to play a role in the underlying pathogenesis of colorectal cancer, but this mechanism is not fully understood,” Vita Jaspan, BA, fourth year medical student at NYU School of Medicine, said in her presentation. “In our study, we wanted to learn how weight impacts colorectal cancer prognosis.”
Investigators searched the literature for studies that reported CRC outcomes at least 60 months after diagnosis with intent to analyze CRC mortality in patients with obesity compared with patients with normal BMI. Researchers also explored overall mortality, disease-free survival, and CRC mortality by BMI category (underweight, normal, overweight and obese), as well as high vs. normal waist circumference.
Researchers identified 15 studies that analyzed CRC outcomes in terms of BMI and two that used waist circumference, comprising 251,347 patients. They found that obesity (OR = 1.27; 95% CI, 1.11–1.45) and underweight (OR = 1.45; 95% CI, 1.13–1.86) were both associated with increased CRC mortality when compared with normal BMI. They were also associated with increased overall mortality (OR = 1.18; 95% CI, 1.05–1.33 and OR = 2.07; 95% CI, 1.48–2.9), while underweight had increased overall mortality compared with obesity.
Additionally, patients with obesity had increased disease-free survival compared with patients with underweight (OR = 1.33; 95% CI, 1.07–1.65). Patients with underweight (OR = 1.41; 95% CI, 1.18–1.69) and obesity (OR = 1.47; 95% CI, 1.02–2.12) also had increased rates of recurrence compared with patients with normal BMI.
Jaspan said patients with underweight and obesity had similar CRC outcomes.
“Patients should be counseled to maintain a normal weight prior to and following colorectal cancer diagnosis,” she said. – by Alex Young
Jaspan, et al. Abstract 72. Presented at: American College of Gastroenterology Annual Meeting; Oct. 25-30, 2019; San Antonio.
Disclosures: Jaspan reports no relevant financial disclosures.