健康生活方式和体重指数与结直肠癌复发和生存的联合关联：一项队列研究。
Combined associations of a healthy lifestyle and body mass index with colorectal cancer recurrence and survival: a cohort study.
机构信息
Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.
Department of Oncology, Södersjukhuset, 118 83, Stockholm, Sweden.
出版信息
Cancer Causes Control. 2024 Feb;35(2):367-376. doi: 10.1007/s10552-023-01802-y. Epub 2023 Oct 2.
PURPOSE
Colorectal cancer (CRC) risk is associated with modifiable lifestyle factors including smoking, physical inactivity, Western diet, and excess body weight. The impact of lifestyle factors on survival is less known. A cohort study was conducted to investigate the combined effects of a healthy lifestyle and body mass index on prognosis following CRC diagnosis.
METHODS
Treatment and follow-up data were collected from the patient files of 1098 participants from the Colorectal cancer low-risk study cohort including stage I-III CRC patients. A healthy lifestyle and BMI (HL) score was computed using self-reported data on smoking status, physical activity, adherence to a Mediterranean diet pattern, and BMI, and divided into four categories ranging from least to most healthy. Survival analyses were performed to assess recurrence-free survival and overall survival across categories of exposure, using the Kaplan-Meier method and Cox proportional hazards models adjusted for age, sex, and educational level.
RESULTS
Among 1098 participants with stage I-III CRC, 233 (21.2%) had an HL score of 0-1 (least healthy), 354 (32.2%) HL score of 2, 357 (32.5%) HL score of 3 and 154 (14.0) HL score 4 (most healthy). Patients with the healthiest lifestyle (HL score 4) compared to the least healthy (HL score 0-1) had an improved recurrence-free survival (HL 4 vs HL 0-1, HRadj 0.51 (95% CI 0.31-0.83) and overall survival (HL 4 vs HL 0-1, HRadj 0.52 (95% CI 0.38-0.70).
CONCLUSION
Adherence to a healthy lifestyle may increase the recurrence-free and overall survival of patients with stage I-III CRC.
目的
结直肠癌（CRC）的风险与可改变的生活方式因素有关，包括吸烟、身体活动不足、西方饮食和体重超标。生活方式因素对生存的影响知之甚少。本队列研究旨在调查健康的生活方式和体重指数（BMI）对 CRC 诊断后预后的综合影响。
方法
从包括 I-III 期 CRC 患者的低危结直肠癌研究队列的 1098 名参与者的病历中收集治疗和随访数据。使用自我报告的吸烟状况、身体活动、对地中海饮食模式的依从性以及 BMI 数据计算健康的生活方式和 BMI（HL）评分，并分为四个类别，范围从最不健康到最健康。使用 Kaplan-Meier 方法和 Cox 比例风险模型，根据年龄、性别和教育水平对暴露的类别进行生存分析，以评估无复发生存率和总生存率。
结果
在 1098 名 I-III 期 CRC 患者中，233 名（21.2%）HL 评分为 0-1（最不健康），354 名（32.2%）HL 评分为 2，357 名（32.5%）HL 评分为 3，154 名（14.0%）HL 评分为 4（最健康）。与最不健康的生活方式（HL 评分为 0-1）相比，生活方式最健康（HL 评分为 4）的患者无复发生存率（HL 4 比 HL 0-1，HRadj 0.51（95%CI 0.31-0.83）和总生存率（HL 4 比 HL 0-1，HRadj 0.52（95%CI 0.38-0.70）均有所改善。
结论
坚持健康的生活方式可能会提高 I-III 期 CRC 患者的无复发生存率和总生存率。
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