*EMBARGOED All research presented at the 2019 ACG Annual Scientific Meeting and Postgraduate Course is strictly embargoed until Monday, October 28, 2019, at 8:00 am CDT.
Oral 72 Impact of Weight Parameters on Colorectal Cancer Survival: A Systematic Review and Meta-Analysis
Author Insight from Vita Jaspan, BA, New York University School of Medicine
What’s new here and important for clinicians?
There is abundant evidence that obesity is linked to the pathophysiology and development of colorectal cancer. However, less is known about the relationship between obesity and colorectal cancer outcomes. Being underweight is associated with poor prognosis and advanced stages of colorectal cancer. Is there an obesity paradox in colorectal cancer survival and recurrence? Is being overweight or obese protective for survival?
Our systematic review and meta-analysis of 251,347 subjects with stage 1 to 3 nonmetastatic colorectal cancer followed for a period of 2.5 to more than 15 years clearly show that obesity is associated with poor colorectal cancer prognosis, including increased cancer-related mortality, decreased odds of disease-free survival, and increased colorectal cancer recurrence. In fact, both obesity and being underweight were associated with poor long-term outcomes (30% increase in colorectal cancer mortality and 20 % increase in overall mortality) compared to subjects with normal weight, as measured with body mass index or high waist circumference in this analysis. Subjects with obesity had similar odds of survival and mortality compared to underweight subjects, who typically represent a subset with cachexia and more advancer disease. Underweight subjects were less likely to have colorectal cancer recurrence than obese subjects.
Thus, it is paramount to council colorectal cancer survivors to maintain healthy weight and waist circumference. Clinicians now have additional evidence to support recommending weight loss to obese patients.
What do patients need to know?
Colorectal cancer (CRC) is the fourth most common cancer diagnosed among adults and the second leading cause of death from cancer. There are some modifiable prognostic factors that can change disease outcomes. One of these is weight. When it comes to cancer, most doctors and patients alike believe that being underweight is a sign of more advanced disease. However, new information shows that being obese can increase the likelihood of developing colorectal cancer in the first place, We wanted to see if this indeed is correct and if having normal weight compared to underweight or being overweight or obese can affect long-term survival, recurrence, and the risk of dying from colorectal cancer. We summarized and systematically reviewed the data from studies that included in total 251,347 patients with stage 1 to 3 nonmetastatic colorectal cancer followed for a period of 2.5 to more than 15 years to see if being overweight or obese can affect outcomes. Patients with colorectal cancer, or who have survived colorectal cancer, tend to live longer and are less likely to develop recurrence of the cancer if they are normal weight. Obese and underweight patients have higher rates of mortality and cancer recurrence. This makes weight one of the few variables that patients can modify to decrease the risk of cancer recurrence and the risk of dying from colorectal cancer. Maintaining healthy weight can not only prevent colorectal cancer from developing but is also associated with better life expectancy and less chance of recurrence in cancer survivors.
Vita Jaspan, BA, New York University School of Medicine
vita.jaspan [at] nyumc [dot] org
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