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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 5/2018

01-05-2018 | Colorectal Cancer

The Negative Impact of Body Mass Index on the Tumor Microenvironment in Colon Cancer: Results of a Prospective Trial

Authors: Devin C. Flaherty, DO, PhD, FACOS, John R. Jalas, MD, PhD, Myung S. Sim, PhD, Alexander Stojadinovic, MD, MBA, FACS, Mladjan Protic, MD, PhD, FACS, Delphine J. Lee, MD, PhD, Anton J. Bilchik, MD, PhD, MBA, FACS

Published in: Annals of Surgical Oncology | Issue 5/2018

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Abstract

Background

The association between tumor mismatch repair status and obesity in colon cancer is not well understood. The authors of this study hypothesized that mismatch repair deficiency in colon cancer may be associated with a lower Body Mass Index (BMI) and improved patient outcome due to an enhanced tumor immune microenvironment.

Methods

For this study, 70 patients were randomly selected from a prospective trial evaluating nodal ultrastaging for colon cancer. The mismatch repair status of tumors and immunomarker expression were correlated with clinicopathologic characteristics and evaluated for disease-free survival.

Results

Patients with mismatch repair-deficient tumors (n = 11) had a lower mean BMI than those with mismatch repair-proficient tumors (n = 59) (22.16 vs. 26.30 kg/m2, respectively; p = 0.029).The findings showed that CD3+ T cells were inversely associated with mismatch repair proficiency (p = 0.048). Mismatch repair-proficient tumors in nonobese patients (BMI < 30 kg/m2) versus obese patients had a higher density of CD8+ (p = 0.008) and FOXP3+ (p = 0.005) T cells. Multivariable analysis linked CD4+ (hazard ratio [HR] 0.52; 95% confidence interval [CI] 0.35–0.76), CD8+ (HR 0.67; 95% CI 0.50–0.89), and number of tumor-positive lymph nodes (HR 1.19; 95% CI 1.03–1.36) to disease-free survival for patients with mismatch repair-proficient tumors.

Conclusions

Tumor mismatch repair status and obesity are correlated in patients with colon cancer. Increased intratumoral T cells in nonobese patients suggests an unexplored link between tumor mismatch repair and immunoprofile.
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Metadata
Title
The Negative Impact of Body Mass Index on the Tumor Microenvironment in Colon Cancer: Results of a Prospective Trial
Authors
Devin C. Flaherty, DO, PhD, FACOS
John R. Jalas, MD, PhD
Myung S. Sim, PhD
Alexander Stojadinovic, MD, MBA, FACS
Mladjan Protic, MD, PhD, FACS
Delphine J. Lee, MD, PhD
Anton J. Bilchik, MD, PhD, MBA, FACS
Publication date
01-05-2018
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 5/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-018-6405-x

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