Dietary glycemic load and cancer recurrence and survival in patients with stage III colon cancer: findings from CALGB 89803.

Journal Article (Journal Article)

BACKGROUND: The influence of glycemic load and related measures on survival among colon cancer patients remains largely unknown. METHODS: We conducted a prospective, observational study of 1011 stage III colon cancer patients reporting dietary intake during and 6 months after participation in an adjuvant chemotherapy trial. We examined the influence of glycemic load, glycemic index, fructose, and carbohydrate intakes on cancer recurrence and mortality using Cox proportional hazards regression; all tests of statistical significance were two-sided. RESULTS: Stage III colon cancer patients in the highest quintile of dietary glycemic load experienced an adjusted hazard ratio (HR) for disease-free survival of 1.79 (95% confidence interval [CI] = 1.29 to 2.48), compared with those in the lowest quintile (P (trend) across quintiles <.001). Increased glycemic load was associated with similar detriments in recurrence-free (P (trend) across quintiles <.001) and overall survival (P (trend) across quintiles <.001). These associations differed statistically significant by body mass index (BMI) (P (interaction) =.01). Whereas glycemic load was not associated with disease-free survival in patients with BMI < 25kg/m(2), higher glycemic load was statistically significant associated with worse disease-free survival among overweight or obese participants (BMI ≥ 25kg/m(2); HR = 2.26; 95% CI = 1.53 to 3.32; P (trend) across quintiles <.001). Increasing total carbohydrate intake was similarly associated with inferior disease-free, recurrence-free, and overall survival (P (trend) across quintiles <.001). CONCLUSION: Higher dietary glycemic load and total carbohydrate intake were statistically significant associated with an increased risk of recurrence and mortality in stage III colon cancer patients. These findings support the role of energy balance factors in colon cancer progression and may offer potential opportunities to improve patient survival.

Full Text

Duke Authors

Cited Authors

  • Meyerhardt, JA; Sato, K; Niedzwiecki, D; Ye, C; Saltz, LB; Mayer, RJ; Mowat, RB; Whittom, R; Hantel, A; Benson, A; Wigler, DS; Venook, A; Fuchs, CS

Published Date

  • November 21, 2012

Published In

Volume / Issue

  • 104 / 22

Start / End Page

  • 1702 - 1711

PubMed ID

  • 23136358

Pubmed Central ID

  • PMC3502194

Electronic International Standard Serial Number (EISSN)

  • 1460-2105

Digital Object Identifier (DOI)

  • 10.1093/jnci/djs399


  • eng

Conference Location

  • United States