Öz
Amaç: Kolon kanseri, dünyada kanser ile ilişkili mortalitenin önde gelen nedenlerinden biri olmaya devam etmektedir. Vücut kitle indeksi (VKİ), kolon kanseri gelişimi için tanımlanmış bir risk faktörü olmasına rağmen, hastalık prognozu üzerindeki etkisiyle ilgili literatürde farklı sonuçlar bildirilmektedir. Ayrıca, sistemik inflamasyon, metabolik değerler ve tümör biyolojisi ile VKİ arasındaki etkileşimin sağkalım üzerindeki rolü henüz tam olarak aydınlatılamamıştır. Bu çalışmanın amacı, kolon kanseri hastalarında VKİ ile birlikte klinikopatolojik ve inflamasyon temelli risk faktörlerinin prognoz üzerindeki etkilerini kapsamlı bir şekilde değerlendirmektir.
Gereç ve Yöntem: Bu retrospektif çalışmaya metastatik olmayan kolon kanseri tanısı almış hastalar dâhil edilmiştir. Hastaların demografik özellikleri, VKİ düzeyleri, klinikopatolojik bulguları, eşlik eden metabolik hastalıkları, inflamasyon temelli hematolojik parametreleri ve moleküler özellikleri analiz edilmiştir. Hastalar VKİ düzeylerine göre gruplandırılmış ve bu gruplar arasında klinik özellikler, hastalıksız sağkalım ve genel sağkalım karşılaştırılmıştır. Sağkalım analizleri Kaplan–Meier yöntemi ile gerçekleştirilmiş, prognostik faktörler Cox regresyon analizi ile değerlendirilmiştir.
Bulgular: Analizler sonucunda VKİ grupları ile genel sağkalım ve hastalıksız sağkalım arasında istatistiksel olarak anlamlı bir ilişki saptanmamıştır. Bununla birlikte, bazı inflamasyon temelli hematolojik parametrelerin ve klinikopatolojik özelliklerin sağkalım ile anlamlı ilişkiler gösterdiği belirlenmiştir. Bulgular, VKİ’nin tek başına prognostik bir belirteç olmadığını, ancak sistemik inflamasyon ve metabolik durum ile birlikte değerlendirildiğinde prognostik değerinin artabileceğini ortaya koymaktadır.
Sonuç: Bu çalışma, kolon kanseri hastalarında VKİ’nin tek başına sağkalımı öngörmede yeterli olmadığını, prognozun daha doğru bir şekilde belirlenebilmesi için inflamasyon temelli biyolojik göstergeler ve klinik faktörlerle birlikte ele alınması gerektiğini göstermektedir. Elde edilen sonuçlar, kolon kanserinde daha bütüncül ve çok boyutlu prognostik modellerin geliştirilmesine katkı sağlayabilecek niteliktedir.
Anahtar Kelimeler
Kolon kanseri Vücut kitle indeksi Prognoz Sağkalım Sistemik inflamasyon
Kaynakça
- Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):17–48. PMID: 38230766
- Van Cutsem E, Cervantes A, Adam R, et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016;27(8):1386–1422. PMID: 27380959
- Dienstmann R, Salazar R, Tabernero J. Personalizing colon cancer adjuvant therapy: selecting optimal treatments for individual patients. J Clin Oncol. 2015;33(16):1787–1796. PMID: 25918284
- Lennon H, Sperrin M, Badrick E, Renehan AG. The obesity paradox in cancer: a review. Curr Oncol Rep. 2016;18(9):56. PMID: 27475829
- Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883–899. PMID: 20303878
- Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014;106(6):dju124. PMID: 24875653
- Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. Diabetes Care. 2010;33(7):1674–1685. PMID: 20587728
- Caan BJ, Meyerhardt JA, Kroenke CH, Alexeeff S, Xiao J, Weltzien E, et al. Explaining the obesity paradox: the association between body composition and colorectal cancer survival. Cancer Epidemiol Biomarkers Prev. 2017;26(7):1008–1015. doi:10.1158/1055-9965.EPI-16-0845. PMID: 28483866.
- Doleman B, Mills KT, Lim S, Zelhart M, Gagliardi G. Body mass index and colorectal cancer prognosis: a systematic review and meta-analysis. Tech Coloproctol. 2016;20(8):517–535. PMID: 27220843
- Meyerhardt JA, Niedzwiecki D, Hollis D, et al. Impact of body mass index and weight change after treatment on cancer recurrence and survival in patients with stage II and III colon cancer. J Clin Oncol. 2008;26(25):4109–4115. doi:10.1200/JCO.2007.15.6687 PMID: 18757330
- Shachar SS, Williams GR, Muss HB, Nishijima TF. Prognostic value of sarcopenia in adults with solid tumours. Eur J Cancer. 2016;57:58–67. PMID: 26882087
- Hobday S, Armache M, Paquin R, et al. The body mass index paradox in head and neck cancer: a systematic review and meta-analysis. Nutr Cancer. 2023;75(1):48-60. doi:10.1080/01635581.2022.2102659 PMID: 35959747
- Brown JC, Caan BJ, Meyerhardt JA, et al. The deterioration of muscle mass and radiodensity is prognostic of poor survival in stage I–III colorectal cancer. Clin Cancer Res. 2018;24(17):4339–4347. doi:10.1158/1078-0432.CCR-18-0123 PMID: 29987017
- Hanahan D, Weinberg RA.Hallmarks of cancer: the next generation.Cell. 2011;144(5):646–674.doi:10.1016/j.cell.2011.02.013 PMID: 21376230
- Prado CM, Baracos VE, McCargar LJ, et al. Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res. 2009;15(8):2920–2926. PMID: 19351764.
- Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436–444. PMID: 18650914.
- Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019;2019:9213074. PMID: 30906584.
- Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47–58. PMID: 21247392.
- Labelle M, Begum S, Hynes RO. Direct signaling between platelets and cancer cells induces an epithelial–mesenchymal-like transition and promotes metastasis. Cancer Cell. 2011;20(5):576–590. PMID: 22094253.
- Jain S, Harris J, Ware J. Platelets: linking hemostasis and cancer. Arterioscler Thromb Vasc Biol. 2010;30(12):2362–2367. PMID: 21071695.
- Gay LJ, Felding-Habermann B. Contribution of platelets to tumour metastasis. Nat Rev Cancer. 2011;11(2):123–134. PMID: 21258396.
- Stone RL, Nick AM, McNeish IA, et al. Paraneoplastic thrombocytosis in ovarian cancer. N Engl J Med. 2012;366(7):610–618. PMID: 22335738.
- Buergy D, Wenz F, Groden C, Brockmann MA. Tumor–platelet interaction in solid tumors. Int J Cancer. 2012;130(12):2747–2760. PMID: 22261860.
- Kwon HC, Kim SH, Oh SY, et al. Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers. 2012;17(3):216–222. PMID: 22385246.
- Guinney J, Dienstmann R, Wang X, et al. The consensus molecular subtypes of colorectal cancer. Nat Med. 2015;21(11):1350–1356. PMID: 26457759.
- Arcidiacono B, Iiritano S, Nocera A, et al. Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res. 2012;2012:789174. PMID: 22110431.
Öz
Aim: Colon cancer remains one of the leading causes of cancer-related mortality worldwide. Although body mass index (BMI) is a well-established risk factor for the development of colon cancer, its impact on disease prognosis has been reported with conflicting results in the literatüre. Moreover, the role of the interaction between BMI, systemic inflammation, metabolic parameters, and tumor biology on survival outcomes remains unclear. The aim of this study was to comprehensively evaluate the prognostic impact of BMI together with clinicopathological and inflammation-based risk factors in patients with colon cancer.
Materials and Methods: This retrospective study included patients diagnosed with colon cancer. Demographic characteristics, BMI levels, clinicopathological findings, accompanying metabolic comorbidities, inflammation-based hematological parameters, and molecular features were analyzed. Patients were stratified according to BMI categories, and clinical characteristics, disease-free survival, and overall survival were compared among these groups. Survival analyses were performed using the Kaplan–Meier method, and prognostic factors were assessed by Cox regression analysis.
Results: No statistically significant association was observed between BMI categories and survival outcomes, specifically overall survival and disease-free survival. In contrast, several inflammation-based hematological parameters and clinicopathological features showed significant associations with survival. This suggests that while BMI alone does not serve as a reliable prognostic marker, its value may be enhanced when considered in conjunction with markers of systemic inflammation and metabolic status.
Conclusion: This study demonstrates that BMI is insufficient to predict survival in colon cancer patients. Prognostic assessment may be improved by integrating inflammation-based biological markers and clinical factors. These results support the development of more comprehensive and multidimensional prognostic models in colon cancer.
Anahtar Kelimeler
Colon cancer Body mass index Prognosis Survival Systemic inflammation
Kaynakça
- Siegel RL, Miller KD, Wagle NS, Jemal A. Cancer statistics, 2024. CA Cancer J Clin. 2024;74(1):17–48. PMID: 38230766
- Van Cutsem E, Cervantes A, Adam R, et al. ESMO consensus guidelines for the management of patients with metastatic colorectal cancer. Ann Oncol. 2016;27(8):1386–1422. PMID: 27380959
- Dienstmann R, Salazar R, Tabernero J. Personalizing colon cancer adjuvant therapy: selecting optimal treatments for individual patients. J Clin Oncol. 2015;33(16):1787–1796. PMID: 25918284
- Lennon H, Sperrin M, Badrick E, Renehan AG. The obesity paradox in cancer: a review. Curr Oncol Rep. 2016;18(9):56. PMID: 27475829
- Grivennikov SI, Greten FR, Karin M. Immunity, inflammation, and cancer. Cell. 2010;140(6):883–899. PMID: 20303878
- Templeton AJ, McNamara MG, Šeruga B, et al. Prognostic role of neutrophil-to-lymphocyte ratio in solid tumors: a systematic review and meta-analysis. J Natl Cancer Inst. 2014;106(6):dju124. PMID: 24875653
- Giovannucci E, Harlan DM, Archer MC, et al. Diabetes and cancer: a consensus report. Diabetes Care. 2010;33(7):1674–1685. PMID: 20587728
- Caan BJ, Meyerhardt JA, Kroenke CH, Alexeeff S, Xiao J, Weltzien E, et al. Explaining the obesity paradox: the association between body composition and colorectal cancer survival. Cancer Epidemiol Biomarkers Prev. 2017;26(7):1008–1015. doi:10.1158/1055-9965.EPI-16-0845. PMID: 28483866.
- Doleman B, Mills KT, Lim S, Zelhart M, Gagliardi G. Body mass index and colorectal cancer prognosis: a systematic review and meta-analysis. Tech Coloproctol. 2016;20(8):517–535. PMID: 27220843
- Meyerhardt JA, Niedzwiecki D, Hollis D, et al. Impact of body mass index and weight change after treatment on cancer recurrence and survival in patients with stage II and III colon cancer. J Clin Oncol. 2008;26(25):4109–4115. doi:10.1200/JCO.2007.15.6687 PMID: 18757330
- Shachar SS, Williams GR, Muss HB, Nishijima TF. Prognostic value of sarcopenia in adults with solid tumours. Eur J Cancer. 2016;57:58–67. PMID: 26882087
- Hobday S, Armache M, Paquin R, et al. The body mass index paradox in head and neck cancer: a systematic review and meta-analysis. Nutr Cancer. 2023;75(1):48-60. doi:10.1080/01635581.2022.2102659 PMID: 35959747
- Brown JC, Caan BJ, Meyerhardt JA, et al. The deterioration of muscle mass and radiodensity is prognostic of poor survival in stage I–III colorectal cancer. Clin Cancer Res. 2018;24(17):4339–4347. doi:10.1158/1078-0432.CCR-18-0123 PMID: 29987017
- Hanahan D, Weinberg RA.Hallmarks of cancer: the next generation.Cell. 2011;144(5):646–674.doi:10.1016/j.cell.2011.02.013 PMID: 21376230
- Prado CM, Baracos VE, McCargar LJ, et al. Sarcopenia as a determinant of chemotherapy toxicity and time to tumor progression in metastatic breast cancer patients receiving capecitabine treatment. Clin Cancer Res. 2009;15(8):2920–2926. PMID: 19351764.
- Mantovani A, Allavena P, Sica A, Balkwill F. Cancer-related inflammation. Nature. 2008;454(7203):436–444. PMID: 18650914.
- Korniluk A, Koper-Lenkiewicz OM, Kamińska J, Kemona H, Dymicka-Piekarska V. Mean platelet volume (MPV): new perspectives for an old marker in the course and prognosis of inflammatory conditions. Mediators Inflamm. 2019;2019:9213074. PMID: 30906584.
- Gasparyan AY, Ayvazyan L, Mikhailidis DP, Kitas GD. Mean platelet volume: a link between thrombosis and inflammation? Curr Pharm Des. 2011;17(1):47–58. PMID: 21247392.
- Labelle M, Begum S, Hynes RO. Direct signaling between platelets and cancer cells induces an epithelial–mesenchymal-like transition and promotes metastasis. Cancer Cell. 2011;20(5):576–590. PMID: 22094253.
- Jain S, Harris J, Ware J. Platelets: linking hemostasis and cancer. Arterioscler Thromb Vasc Biol. 2010;30(12):2362–2367. PMID: 21071695.
- Gay LJ, Felding-Habermann B. Contribution of platelets to tumour metastasis. Nat Rev Cancer. 2011;11(2):123–134. PMID: 21258396.
- Stone RL, Nick AM, McNeish IA, et al. Paraneoplastic thrombocytosis in ovarian cancer. N Engl J Med. 2012;366(7):610–618. PMID: 22335738.
- Buergy D, Wenz F, Groden C, Brockmann MA. Tumor–platelet interaction in solid tumors. Int J Cancer. 2012;130(12):2747–2760. PMID: 22261860.
- Kwon HC, Kim SH, Oh SY, et al. Clinical significance of preoperative neutrophil-lymphocyte versus platelet-lymphocyte ratio in patients with operable colorectal cancer. Biomarkers. 2012;17(3):216–222. PMID: 22385246.
- Guinney J, Dienstmann R, Wang X, et al. The consensus molecular subtypes of colorectal cancer. Nat Med. 2015;21(11):1350–1356. PMID: 26457759.
- Arcidiacono B, Iiritano S, Nocera A, et al. Insulin resistance and cancer risk: an overview of the pathogenetic mechanisms. Exp Diabetes Res. 2012;2012:789174. PMID: 22110431.
Ayrıntılar
| Birincil Dil | Türkçe |
|---|---|
| Konular | Klinik Onkoloji |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Gönderilme Tarihi | 22 Ocak 2026 |
| Kabul Tarihi | 5 Şubat 2026 |
| Yayımlanma Tarihi | 9 Mart 2026 |
| DOI | https://doi.org/10.19161/etd.1869544 |
| IZ | https://izlik.org/JA46AA26NC |
| Yayımlandığı Sayı | Yıl 2026 Cilt: 65 Sayı: 1 |
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