Published October 30, 2020 | Version v1
Journal article Open

Association of Diet Quality with Survival among People with Metastatic Colorectal Cancer in the Cancer and Leukemia B and Southwest Oncology Group 80405 Trial

  • 1. University of California, San Francisco
  • 2. Dana-Farber Cancer Institute
  • 3. Mayo Clinic
  • 4. Duke University
  • 5. Harvard University
  • 6. University of Southern California
  • 7. University of North Carolina at Chapel Hill
  • 8. Indiana University
  • 9. Virginia Commonwealth University
  • 10. University of Chicago
  • 11. Yale University
  • 12. Southeast Clinical Oncology Research Consortium
  • 13. West Virginia University Cancer Institute
  • 14. Oregon Health & Science University
  • 15. Memorial Sloan Kettering Cancer Center

Description

Importance: Diet has been associated with survival in patients with stage I to III colorectal cancer, but data on patients with metastatic colorectal cancer are limited.

Objective: To examine the association between diet quality and overall survival among individuals with metastatic colorectal cancer.

Design, Setting, and Participants: This was a prospective cohort study of patients with metastatic colorectal cancer who were enrolled in the Cancer and Leukemia Group B (Alliance) and Southwest Oncology Group 80405 trial between October 27, 2005, and February 29, 2012, and followed up through January 2018. Exposures: Participants completed a validated food frequency questionnaire within 4 weeks after initiation of first-line treatment for metastatic colorectal cancer. Diets were categorized according to the Alternative Healthy Eating Index (AHEI), Alternate Mediterranean Diet (AMED) score, Dietary Approaches to Stop Hypertension (DASH) score, and Western and prudent dietary patterns derived using principal component analysis. Participants were categorized into sex-specific quintiles.

Main Outcomes and Measures: Multivariable hazard ratios (HRs) and 95% CIs for overall survival.

Results: In this cohort study of 1284 individuals with metastatic colorectal cancer, the median age was 59 (interquartile range [IQR]: 51-68) years, median body mass index was 27.2 (IQR, 24.1-31.4), 521 (41%) were female, and 1102 (86%) were White. There were 1100 deaths during a median follow-up of 73 months (IQR, 64-87 months). We observed an inverse association between the AMED score and risk of death (HR quintile 5 vs quintile 1, 0.83; 95% CI, 0.67-1.04; P =.04 for trend), but the point estimates were not statistically significant. None of the other diet scores or patterns were associated with overall survival.

Conclusions and Relevance: In this prospective analysis of patients with metastatic colorectal cancer, diet quality assessed at initiation of first-line treatment for metastatic disease was not associated with overall survival.

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Additional details

Identifiers

DOI
10.1001/jamanetworkopen.2020.23500
Other
oai:uchicago.tind.io:11154

Funding

National Cancer Institute
U10CA180821
National Cancer Institute
U10CA180882
National Cancer Institute
U10CA180888
National Cancer Institute
UG1CA180830
National Cancer Institute
UG1CA233373
National Cancer Institute
UG1CA233290
National Cancer Institute
UG1CA233180
National Cancer Institute
UG1CA189858
National Cancer Institute
UG1CA233337
National Cancer Institute
R01CA205406
National Cancer Institute
K07CA197077
National Cancer Institute
P30CA016359
National Cancer Institute
R01CA169141
National Cancer Institute
R01CA118553
Bristol Myers Squibb
Genentech
Pfizer
Sanofi
Unknown funder
Douglas Gray Woodruff Chair fund
Unknown funder
Guo Shu Shi Fund
Unknown funder
Anonymous Family Fund for Innovations in Colorectal Cancer
Unknown funder
Project P Fund
George Stone Family Foundation
Unknown funder
DOD CA160344
Stand Up To Cancer
Colorectal Cancer Dream Team Translational Research Grant

UChicago Information

Division(s)
Pritzker School of Medicine