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

• Published in: Supportive care in cancer Vol. 27; no. 4; pp. 1541 - 1549
• Main Authors: van Zutphen, Moniek, Geelen, Anouk, Boshuizen, Hendriek C., Winkels, Renate M., Geijsen, Anne J.M.R., Wesselink, Evertine, Snellen, Merel, Kok, Dieuwertje E., de Wilt, Johannes H.W., van de Meeberg, Paul C., Kouwenhoven, Ewout A., van Halteren, Henk K., Spillenaar Bilgen, Ernst J., Kampman, Ellen, van Duijnhoven, Fränzel J.B.
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2019; Springer; Springer Nature B.V
• Subjects: Adjuvant chemotherapy; Aged; Body Weight - drug effects; Body Weight - physiology; Body-Weight Trajectory; Cancer metastasis; Cancer patients; Cancer research; Cancer treatment; Care and treatment; Chemotherapy; Chemotherapy, Adjuvant - adverse effects; Colorectal cancer; Colorectal Neoplasms - diagnosis; Colorectal Neoplasms - drug therapy; Colorectal Neoplasms - epidemiology; Colorectal Neoplasms - physiopathology; Comparative analysis; Disease Progression; Female; Health; Health aspects; Humans; Long term; Male; Medical diagnosis; Medical research; Medical schools; Medicine; Medicine & Public Health; Middle Aged; Netherlands - epidemiology; Nursing; Nursing Research; Oncology; Original; Original Article; Pain Medicine; Prevention; Quantitative analysis; Rehabilitation Medicine; Survivor; Weight; Weight change; Weight gain; Weight Gain - drug effects; Weight Loss - drug effects; Netherlands; Chemotherapy; Weight change; Weight gain; Colorectal cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-018-4560-z

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.