Joint prognostic effect of obesity and chronic systemic inflammation in patients with metastatic colorectal cancer

BACKGROUND Obesity is strongly linked with chronic systemic inflammation, and each has been linked with disease progression and survival in patients with colorectal cancer (CRC). The authors investigated the joint prognostic effects of obesity and circulating cytokines in patients with metastatic CRC (mCRC), an understudied patient group. METHODS In 242 chemotherapy‐naive patients with mCRC, the authors measured a multiplex cytokine panel and ed clinicopathological features, height, and weight from medical records. Overall survival (OS) was calculated from the date of mCRC diagnosis until the date of death from any cause and evaluated by Kaplan‐Meier analysis and multivariable Cox proportional hazards regression models. Cut points for cytokines were determined by restricted cubic spline regression. RESULTS In multivariable models, elevated interleukin (IL)−8, IL‐2 receptor alpha, and lactate dehydrogenase (LDH) emerged as significant predictors of poor OS (hazard ratio [HR] and 95% confidence interval [95% CI] for above vs below the (referent) knot point: 2.5 [95% CI, 1.7‐3.7], 1.9 [95% CI, 1.3‐2.7], and 2.2 [95% CI, 1.6‐3.1], respectively; all P