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Pre-to-post diagnosis weight trajectories in colorectal cancer patients with non-metastatic disease.

AbstractPURPOSE:
Previous studies have shown that > 50% of colorectal cancer (CRC) patients treated with adjuvant chemotherapy gain weight after diagnosis. This may affect long-term health. Therefore, prevention of weight gain has been incorporated in oncological guidelines for CRC with a focus on patients that undergo adjuvant chemotherapy treatment. It is, however, unknown how changes in weight after diagnosis relate to weight before diagnosis and whether weight changes from pre-to-post diagnosis are restricted to chemotherapy treatment. We therefore examined pre-to-post diagnosis weight trajectories and compared them between those treated with and without adjuvant chemotherapy.
METHODS:
We included 1184 patients diagnosed with stages I-III CRC between 2010 and 2015 from an ongoing observational prospective study. At diagnosis, patients reported current weight and usual weight 2 years before diagnosis. In the 2 years following diagnosis, weight was self-reported repeatedly. We used linear mixed models to analyse weight trajectories.
RESULTS:
Mean pre-to-post diagnosis weight change was -0.8 (95% CI -1.1, -0.4) kg. Post-diagnosis weight gain was + 3.5 (95% CI 2.7, 4.3) kg in patients who had lost ≥ 5% weight before diagnosis, while on average clinically relevant weight gain after diagnosis was absent in the groups without pre-diagnosis weight loss. Pre-to-post diagnosis weight change was similar in patients treated with (-0.1 kg (95%CI -0.8, 0.6)) and without adjuvant chemotherapy (-0.9 kg (95%CI -1.4, -0.5)).
CONCLUSIONS:
Overall, hardly any pre-to-post diagnosis weight change was observed among CRC patients, because post-diagnosis weight gain was mainly observed in patients who lost weight before diagnosis. This was observed independent of treatment with adjuvant chemotherapy.
AuthorsMoniek van Zutphen, Anouk Geelen, Hendriek C Boshuizen, Renate M Winkels, Anne J M R Geijsen, Evertine Wesselink, Merel Snellen, Dieuwertje E Kok, Johannes H W de Wilt, Paul C van de Meeberg, Ewout A Kouwenhoven, Henk K van Halteren, Ernst J Spillenaar Bilgen, Ellen Kampman, Fränzel J B van Duijnhoven
JournalSupportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (Support Care Cancer) Vol. 27 Issue 4 Pg. 1541-1549 (Apr 2019) ISSN: 1433-7339 [Electronic] Germany
PMID30484014 (Publication Type: Journal Article, Multicenter Study, Observational Study)
Topics
  • Aged
  • Body Weight (drug effects, physiology)
  • Body-Weight Trajectory
  • Chemotherapy, Adjuvant (adverse effects)
  • Colorectal Neoplasms (diagnosis, drug therapy, epidemiology, physiopathology)
  • Disease Progression
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands (epidemiology)
  • Weight Gain (drug effects)
  • Weight Loss (drug effects)

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