Study: Coffee can reduce the recurrence of colon cancer

Reference Guercio BJ, Sato K, Niedzwiecki D, et al. Coffee consumption, recurrence and mortality in colon cancer in stage III: Results from CalGB 89803 (Alliance). J clin oncol. August 17, 2015. [Epub Ahead of Print] Design prospective observation study embedded in a randomized study participants have taken part in a randomly crab (n = 953) who have already participated in a separate, randomized clinical study sponsored by the National Cancer Institute, in which two chemotherapy schema were compared. All patients had colon cancer in stage III, were subjected to complete surgical resection, had no signs of distant metastases and were overall in relatively good health (0 to 2 on the Eastern ...

01. März 2023

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Reference

Guercio BJ, Sato K, Niedzwiecki D, et al. Coffee consumption, recurrence and mortality in colon cancer in stage III: Results from CalGB 89803 (Alliance). j clin oncol. 17. August 2015. [Epub Ahead of Print]

Design

prospective observation study embedded in a randomized study

participant

have participated in people with colon cancer (n = 953) who have already participated in a separate, randomized clinical study sponsored by the National Cancer Institute, in which two chemotherapy schemes were compared. All patients had colon cancer in stage III, were subjected to a complete surgical resection, had no signs of distant metastases and were overall in relatively good health (0 to 2 on the Eastern Cooperative Oncology Group Scale). All suitable participants also had an appropriate bone marrow, kidney and liver function. The exclusion criteria included false/incomplete questionnaire results, recurrence of cancer or death of any cause within 3 months after filling out the questionnaire and extremely high or extremely low calorie intake (4200 kcal/day for men; 3500 CAL/D for women).

target parameter

Ein Fragebogen zur Ernährungshäufigkeit wurde in der Mitte der adjuvanten Behandlung von Dickdarmkrebs (Q1, ungefähr 4 Monate nach der Operation) und 6 Monate nach Abschluss der Behandlung (Q2, 14 Monate nach der Operation) ausgegeben. The participants were asked about the consumption of caffeinated coffee, decaffeinated coffee, non-herbal tea, herbal tea, caffeinated soft drinks and chocolate. There were 5 frequency categories for overall coffee, caffeinated coffee and tea (0, 4 c/d). Uncaffeinated coffee had 3 frequency categories (0, 2 c/d) to maintain the statistical meaning.

The primary endpoint was the disease -free survival, which was defined as a time from the conclusion from Q1 to recurrence, the occurrence of a new primary intestinal cancer or the death of any cause. One of the secondary result parameters was the overall survival (OS), which was defined as the time from the end of Q1 to the death of any cause. The recurrent survival, i.e. h. The time from the completion of Q1 to recurrence or the occurrence of a new primary colon cancer is also evaluated.

The original clinical study in which this observation study was carried out found no difference between the poor, so that all patients could be pooled for this analysis, without hesitation regarding treatment as a confounder. The median follow -up time from Q1 until the end was 7.3 years.

important knowledge

Overall, an increase in the total coffee consumption was associated with a significant reduction in relapse or mortality risk after other predictors were adjusted for the recurrence of cancer.

During this time, 329 of the 953 participants had a recurrence or a new primary intestinal cancer. 288 of them died of their illness. Thirty -six participants died of other causes and without signs of colon cancer.

compared to abstinence learners, those who consumed more than 4 cups of coffee per day (caffeinated plus decaffeinated) had a 41 % lower risk of relapse (Hazard Ratio [HR]: 0.59; p = 0.003). An increase in the overall absorption of coffee was also associated with a significant improvement in the OS ( p = 0.008).

Coffee containing caffeine in particular showed an even greater risk reduction. Compared to abstinence, those who consumed more than 4 cups of coffee per day had a 51 % lower risk or mortality risk (HR: 0.49; p = 0.003).

The total coffin recording was also associated with a benefit. There was a 35 percent reduction in recurrences and mortality in the highest quintile of caffeine intake (HR: 0.65, p = 0.005).

neither the absorption of non-herbal tea nor decaffeinated coffee was associated with the treatment results of the patients. The results remained unchanged when they were adjusted for sweetener -sweetened drinks, dietary glycemic stress, western vs. prudent dietary habits or physical activity.

practice implications

It is estimated that 1 out of 20 Americans falls on intestinal cancer in the course of his life. ^{1 After lung cancer, the second most common cause of cancer deaths as a whole is. (If analyzes according to gender, prostate and breast cancer are the second most common cause and colon cancer is the third.)}

Despite these dark facts, colon cancer has a commendable award within oncology: Deaths from colon cancer have been declining for over 20 years. 2 This is primarily due to earlier detection through colonoscopy and better access to treatment. In January 2014 there were around 1.3 million people with a history of colon cancer in the United States. ^{3 The likelihood that general practitioners with colon cancer will see in their practices is quite high and grows further.}

The likelihood that general practitioners will see patients with colon cancer in their practices is quite high and grows further.

The present publication seems to be the first prospective study on coffee consumption and recurrence or survival of colon cancer. Systematic overviews of intestinal cancer and coffee consumption were inconsistent, which indicates an reverse association 4 or no statistically significant relationship. 5 The current publication indicates that there is a reverse connection between coffee consumption and both the recurrence of thick intestine cancer.

When coffee lowers the recurrence rate, what is the mechanism? There are 2 wide options. Either there are systemic effects, such as the influence of coffee on insulin and glucose control, or there are secondary plant substances in the coffee bean that act directly on cancer and/or immune cells.

colon cancer is strongly associated with an excessive energy balance, especially with obesity, insulinemia and type 2 diabetes. ^{6 It is known that coffee reduces the risk of type 2 diabetes ^{7.8 Insulin, ^{9 Increase. 10 The authors of the examined study placed the hypothesis that these favorable effects of coffee on insulin and energy balance could influence the result in patients with colon cancer in history. While the study did not evaluate blood sugar parameters per se, it is plausible that the obvious benefit of coffee is due to its known effects on improved energy control and use.

The excess energy balance is largely influenced by nutrition and movement. It is fascinating that sugar -sweetened drinks that did not change the results in this study. This implies that a different mechanism may be at work. In fact, phytochemicals contained in coffee beans can have direct cancer -inhibiting effects.

In a mouse model for colon cancer, it was found that the phenolic secondary plant substances from coffee (coffee acid and chlorogenic acid) reduce metastasis in the lungs. ^{11 in the same study, used in the rescited thick-intestine cancer fabric (10 coffee drinkers, 10 non-coffee drinkers) It is in the inhibition of the necessary growth path in which the necessary growth was involved in those who consumed coffee. This implies that there is direct inhibition of intracellular growth signals through coffee components. In this study, the effect was independent of the caffeine content, since 6 of the 10 coffee drinkers decaffeinated coffee consumed.}

In a case control study that aimed to identify relevant biomarkers for coffee consumption, 251 colon cancer patients and 247 suitable checks were compared. There were 29 serve tabolites that correlated closely with coffee consumption. In particular, three metabolites - theophylline, caffeine and paraxethin - were conversely associated with colon cancer. ¹²

As always, in observation studies, all associated risks and/or advantages can be a replacement for other behaviors that influence the result. Interessant an der untersuchten Studie ist, dass diejenigen, die am meisten Kaffee konsumierten, eher Raucher mit einer kalorienreicheren Ernährung und einem weniger umsichtigen Ernährungsmuster waren. However, they were also more physically active and tends to eat lower glycemic. Taken together, this confounder confirm the conclusion that it is actually the coffee/caffeine consumption that brings advantages.

As with all interventions, the risks of coffee consumption must be weighed against the benefit. Gastric ulcers, high blood pressure or anxiety are some conditions in the history of a patient who can exclude the consumption of caffeinated coffee. In view of the obvious use that emerges from this study, we should not discourage patients who enjoy coffee without obvious consequences. While we find the difference between use and misuse of caffeine or coffee in every patient, we should pass on the current state of the evidence for all possible measures that can reduce the risk of relapse. Our advice on coffee may object to the assumptions of many patients, but the transmission of evidence, especially if they are unexpected, is a valuable part of our service as a practitioner.}}}

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