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

Moniek 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

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)

Abstract

Purpose: 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.

Original languageEnglish
Pages (from-to)1541-1549
JournalSupportive Care in Cancer
Volume27
Issue number4
Early online date27 Nov 2018
DOIs
Publication statusPublished - Apr 2019

Keywords

  • Chemotherapy
  • Colorectal cancer
  • Weight change
  • Weight gain

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