III期结肠癌患者的咖啡摄入量、复发率及死亡率：CALGB 89803（联盟）研究结果
Coffee Intake, Recurrence, and Mortality in Stage III Colon Cancer: Results From CALGB 89803 (Alliance).
作者信息
Guercio Brendan J, Sato Kaori, Niedzwiecki Donna, Ye Xing, Saltz Leonard B, Mayer Robert J, Mowat Rex B, Whittom Renaud, Hantel Alexander, Benson Al, Atienza Daniel, Messino Michael, Kindler Hedy, Venook Alan, Hu Frank B, Ogino Shuji, Wu Kana, Willett Walter C, Giovannucci Edward L, Meyerhardt Jeffrey A, Fuchs Charles S
机构信息
Brendan J. Guercio, Shuji Ogino, and Edward L. Giovannucci, Harvard Medical School; Kaori Sato, Robert J. Mayer, Shuji Ogino, Jeffrey A. Meyerhardt, and Charles S. Fuchs, Dana-Farber Cancer Institute; Frank B. Hu, Shuji Ogino, Kana Wu, Walter C. Willett, and Edward L. Giovannucci, Harvard T.H. Chan School of Public Health; Shuji Ogino and Edward L. Giovannucci, Brigham and Women's Hospital, Boston, MA; Leonard B. Saltz, Memorial Sloan Kettering Cancer Center, New York, NY; Rex B. Mowat, Toledo Community Hospital Oncology Program, Toledo, OH; Renaud Whittom, Hôpital du Sacré-Coeur de Montréal, Montreal, Quebec, Canada; Alexander Hantel, Loyola University Stritch School of Medicine, Naperville; Al Benson, Northwestern University; Hedy Kindler, University of Chicago, Chicago, IL; Daniel Atienza, Virginia Oncology Associates, Norfolk, VA; Donna Niedzwiecki and Xing Ye, Duke University Medical Center, Durham; Michael Messino, Southeast Cancer Control Consortium, Mission Hospitals, Asheville, NC; and Alan Venook, University of California at San Francisco Comprehensive Cancer Center, San Francisco, CA.
出版信息
J Clin Oncol. 2015 Nov 1;33(31):3598-607. doi: 10.1200/JCO.2015.61.5062. Epub 2015 Aug 17.
PURPOSE
Observational studies have demonstrated increased colon cancer recurrence in states of relative hyperinsulinemia, including sedentary lifestyle, obesity, and increased dietary glycemic load. Greater coffee consumption has been associated with decreased risk of type 2 diabetes and increased insulin sensitivity. The effect of coffee on colon cancer recurrence and survival is unknown.
PATIENTS AND METHODS
During and 6 months after adjuvant chemotherapy, 953 patients with stage III colon cancer prospectively reported dietary intake of caffeinated coffee, decaffeinated coffee, and nonherbal tea, as well as 128 other items. We examined the influence of coffee, nonherbal tea, and caffeine on cancer recurrence and mortality using Cox proportional hazards regression.
RESULTS
Patients consuming 4 cups/d or more of total coffee experienced an adjusted hazard ratio (HR) for colon cancer recurrence or mortality of 0.58 (95% CI, 0.34 to 0.99), compared with never drinkers (Ptrend = .002). Patients consuming 4 cups/d or more of caffeinated coffee experienced significantly reduced cancer recurrence or mortality risk compared with abstainers (HR, 0.48; 95% CI, 0.25 to 0.91; Ptrend = .002), and increasing caffeine intake also conferred a significant reduction in cancer recurrence or mortality (HR, 0.66 across extreme quintiles; 95% CI, 0.47 to 0.93; Ptrend = .006). Nonherbal tea and decaffeinated coffee were not associated with patient outcome. The association of total coffee intake with improved outcomes seemed consistent across other predictors of cancer recurrence and mortality.
CONCLUSION
Higher coffee intake may be associated with significantly reduced cancer recurrence and death in patients with stage III colon cancer.
目的
观察性研究表明，在相对高胰岛素血症状态下，包括久坐不动的生活方式、肥胖和饮食中血糖负荷增加，结肠癌复发率会升高。咖啡摄入量增加与2型糖尿病风险降低及胰岛素敏感性增加有关。咖啡对结肠癌复发和生存的影响尚不清楚。
患者与方法
在辅助化疗期间及化疗后6个月，953例III期结肠癌患者前瞻性报告了含咖啡因咖啡、脱咖啡因咖啡和非草药茶以及其他128种食物的饮食摄入量。我们使用Cox比例风险回归分析了咖啡、非草药茶和咖啡因对癌症复发和死亡率的影响。
结果
与从不喝咖啡的患者相比，每天饮用4杯或更多总咖啡的患者结肠癌复发或死亡的校正风险比（HR）为0.58（95%CI，0.34至0.99）（P趋势=0.002）。与不喝咖啡的患者相比，每天饮用4杯或更多含咖啡因咖啡的患者癌症复发或死亡风险显著降低（HR，0.48；95%CI，0.25至0.91；P趋势=0.002），且咖啡因摄入量增加也使癌症复发或死亡显著降低（极端五分位数间HR为0.66；95%CI，0.47至0.93；P趋势=0.006）。非草药茶和脱咖啡因咖啡与患者预后无关。总咖啡摄入量与预后改善之间的关联在癌症复发和死亡的其他预测因素中似乎是一致的。
结论
较高的咖啡摄入量可能与III期结肠癌患者癌症复发和死亡显著降低有关。
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