Marine omega‐3 fatty acid intake and survival of stage III colon cancer according to tumor molecular markers in NCCTG Phase III trial N0147 (Alliance)
Marine omega‐3 polyunsaturated fatty acids (MO3PUFAs) have anticancer properties and may improve colon cancer survival. However, it remains unknown whether the benefit differs by tumor molecular subtype. We examined data from a phase III randomized trial of FOLFOX or FOLFOX + cetuximab among 1,735 s...
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| Veröffentlicht in: | International journal of cancer 2019-07, Vol.145 (2), p.380-389 |
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| creator | Song, Mingyang Ou, Fang‐Shu Zemla, Tyler J. Hull, Mark A. Shi, Qian Limburg, Paul J. Alberts, Steven R. Sinicrope, Frank A. Giovannucci, Edward L. Van Blarigan, Erin L. Meyerhardt, Jeffrey A. Chan, Andrew T. |
| description | Marine omega‐3 polyunsaturated fatty acids (MO3PUFAs) have anticancer properties and may improve colon cancer survival. However, it remains unknown whether the benefit differs by tumor molecular subtype. We examined data from a phase III randomized trial of FOLFOX or FOLFOX + cetuximab among 1,735 stage III colon cancer patients who completed a dietary questionnaire at enrollment. Multivariable hazard ratios and 95% confidence intervals (CIs) were calculated for the association between MO3PUFA and disease‐free survival (DFS) and overall survival according to KRAS and BRAFV600E mutations and DNA mismatch repair (MMR) status. Higher MO3PUFA intake was associated with improved 3‐year DFS for KRAS wild‐type tumors (77% vs. 73%; HR: 0.84; 95% CI: 0.67–1.05) but not KRAS‐mutant tumors (64% vs. 70%; HR: 1.30; 95% CI: 0.97–1.73; Pinteraction = 0.02). Similar heterogeneity was found by MMR (Pinteraction = 0.14): higher MO3PUFA was associated with better 3‐year DFS for tumors with deficient MMR (72% vs. 67%) but not proficient MMR (72% vs. 72%). No heterogeneity was found by BRAFV600E mutation. Similar findings were obtained for overall survival. In conclusion, we found a suggestive beneficial association between higher MO3PUFA intake and improved survival among stage III colon cancer patients with wild‐type KRAS and deficient MMR. Given the relatively small number of cases with tumor molecular assessments, further studies, preferably through pooled analyses of multiples cohorts, are needed to validate our findings.
What's new?
Consumption of fish oil or related products containing marine omega‐3 polyunsaturated fatty acid (MO3PUFA) has long been associated with health benefits but effects on cancer survival remain unclear. Here the authors find tentative evidence that MO3PUFA supplementation in patients with stage III colon cancer is associated with better survival, but the benefit was restricted to tumors lacking mutations in the KRAS proto‐oncogene and arising from the microsatellite instability pathway, a finding with possible implications for improving patient care. |
| doi_str_mv | 10.1002/ijc.32113 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6525069</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2226369515</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4433-fb1df6efac973b00bbb8e36912d31a93f9f58b37288a2f8b6d54c3ec1ad026673</originalsourceid><addsrcrecordid>eNp1kc1u1DAURi0EokNhwQsgS2zoIq1_EifZIFURlKBSWJS1dePYU08zdrGdQbPjEVjyfDwJLikVLFhdS_f43E_6EHpOyTElhJ3YjTrmjFL-AK0oaeuCMFo9RKu8I0VNuThAT2LcEEJpRcrH6IATwXjJyAr9-ADBOo39Vq_h57fvHBtIaY9B2RFbl-BaY3AjjnPY2R1M2BscE6w17vseKz95hxU4pUP-onwYrVvj5HGatz7grZ-0mifILwjXOsSsxBddd3mGP11BXCQp2Oy9ILSs8avTabK3uqOn6JGBKepnd_MQfX775rJ7V5x_POu70_NClSXnhRnoaIQ2oNqaD4QMw9BoLlrKRk6h5aY1VTPwmjUNMNMMYqxKxbWiMBImRM0P0evFezMPWz0q7VKASd4EmyPvpQcr_904eyXXfidFxSoi2ix4eScI_susY5IbPweXM0vGmMhZKlpl6mihVPAxBm3uL1Aib0uUuUT5u8TMvvg70j35p7UMnCzAVzvp_f9Nsn_fLcpfvpunSg</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2226369515</pqid></control><display><type>article</type><title>Marine omega‐3 fatty acid intake and survival of stage III colon cancer according to tumor molecular markers in NCCTG Phase III trial N0147 (Alliance)</title><source>Wiley-Blackwell Journals</source><source>MEDLINE</source><source>EZB Electronic Journals Library</source><creator>Song, Mingyang ; Ou, Fang‐Shu ; Zemla, Tyler J. ; Hull, Mark A. ; Shi, Qian ; Limburg, Paul J. ; Alberts, Steven R. ; Sinicrope, Frank A. ; Giovannucci, Edward L. ; Van Blarigan, Erin L. ; Meyerhardt, Jeffrey A. ; Chan, Andrew T.</creator><creatorcontrib>Song, Mingyang ; Ou, Fang‐Shu ; Zemla, Tyler J. ; Hull, Mark A. ; Shi, Qian ; Limburg, Paul J. ; Alberts, Steven R. ; Sinicrope, Frank A. ; Giovannucci, Edward L. ; Van Blarigan, Erin L. ; Meyerhardt, Jeffrey A. ; Chan, Andrew T.</creatorcontrib><description>Marine omega‐3 polyunsaturated fatty acids (MO3PUFAs) have anticancer properties and may improve colon cancer survival. However, it remains unknown whether the benefit differs by tumor molecular subtype. We examined data from a phase III randomized trial of FOLFOX or FOLFOX + cetuximab among 1,735 stage III colon cancer patients who completed a dietary questionnaire at enrollment. Multivariable hazard ratios and 95% confidence intervals (CIs) were calculated for the association between MO3PUFA and disease‐free survival (DFS) and overall survival according to KRAS and BRAFV600E mutations and DNA mismatch repair (MMR) status. Higher MO3PUFA intake was associated with improved 3‐year DFS for KRAS wild‐type tumors (77% vs. 73%; HR: 0.84; 95% CI: 0.67–1.05) but not KRAS‐mutant tumors (64% vs. 70%; HR: 1.30; 95% CI: 0.97–1.73; Pinteraction = 0.02). Similar heterogeneity was found by MMR (Pinteraction = 0.14): higher MO3PUFA was associated with better 3‐year DFS for tumors with deficient MMR (72% vs. 67%) but not proficient MMR (72% vs. 72%). No heterogeneity was found by BRAFV600E mutation. Similar findings were obtained for overall survival. In conclusion, we found a suggestive beneficial association between higher MO3PUFA intake and improved survival among stage III colon cancer patients with wild‐type KRAS and deficient MMR. Given the relatively small number of cases with tumor molecular assessments, further studies, preferably through pooled analyses of multiples cohorts, are needed to validate our findings.
What's new?
Consumption of fish oil or related products containing marine omega‐3 polyunsaturated fatty acid (MO3PUFA) has long been associated with health benefits but effects on cancer survival remain unclear. Here the authors find tentative evidence that MO3PUFA supplementation in patients with stage III colon cancer is associated with better survival, but the benefit was restricted to tumors lacking mutations in the KRAS proto‐oncogene and arising from the microsatellite instability pathway, a finding with possible implications for improving patient care.</description><identifier>ISSN: 0020-7136</identifier><identifier>EISSN: 1097-0215</identifier><identifier>DOI: 10.1002/ijc.32113</identifier><identifier>PMID: 30623420</identifier><language>eng</language><publisher>Hoboken, USA: John Wiley & Sons, Inc</publisher><subject>Aged ; Cancer ; Cetuximab - therapeutic use ; Colon cancer ; Colonic Neoplasms - diet therapy ; Colonic Neoplasms - drug therapy ; Colonic Neoplasms - genetics ; Colorectal cancer ; Disease-Free Survival ; DNA repair ; Fatty Acids, Omega-3 - administration & dosage ; Female ; Fish Oils - administration & dosage ; Fluorouracil - therapeutic use ; Heterogeneity ; Humans ; inflammation ; Male ; Medical research ; Microsatellite Instability ; Middle Aged ; Mismatch repair ; Monoclonal antibodies ; Mutation ; Neoplasm Staging ; nutrition ; Omega-3 fatty acids ; Polyunsaturated fatty acids ; Proto-Oncogene Proteins B-raf - genetics ; Proto-Oncogene Proteins p21(ras) - genetics ; Survival ; survivorship care ; Targeted cancer therapy ; Treatment Outcome ; tumor microenvironment ; Tumors</subject><ispartof>International journal of cancer, 2019-07, Vol.145 (2), p.380-389</ispartof><rights>2019 UICC</rights><rights>2019 UICC.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4433-fb1df6efac973b00bbb8e36912d31a93f9f58b37288a2f8b6d54c3ec1ad026673</citedby><cites>FETCH-LOGICAL-c4433-fb1df6efac973b00bbb8e36912d31a93f9f58b37288a2f8b6d54c3ec1ad026673</cites><orcidid>0000-0002-1324-0316</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fijc.32113$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fijc.32113$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30623420$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Song, Mingyang</creatorcontrib><creatorcontrib>Ou, Fang‐Shu</creatorcontrib><creatorcontrib>Zemla, Tyler J.</creatorcontrib><creatorcontrib>Hull, Mark A.</creatorcontrib><creatorcontrib>Shi, Qian</creatorcontrib><creatorcontrib>Limburg, Paul J.</creatorcontrib><creatorcontrib>Alberts, Steven R.</creatorcontrib><creatorcontrib>Sinicrope, Frank A.</creatorcontrib><creatorcontrib>Giovannucci, Edward L.</creatorcontrib><creatorcontrib>Van Blarigan, Erin L.</creatorcontrib><creatorcontrib>Meyerhardt, Jeffrey A.</creatorcontrib><creatorcontrib>Chan, Andrew T.</creatorcontrib><title>Marine omega‐3 fatty acid intake and survival of stage III colon cancer according to tumor molecular markers in NCCTG Phase III trial N0147 (Alliance)</title><title>International journal of cancer</title><addtitle>Int J Cancer</addtitle><description>Marine omega‐3 polyunsaturated fatty acids (MO3PUFAs) have anticancer properties and may improve colon cancer survival. However, it remains unknown whether the benefit differs by tumor molecular subtype. We examined data from a phase III randomized trial of FOLFOX or FOLFOX + cetuximab among 1,735 stage III colon cancer patients who completed a dietary questionnaire at enrollment. Multivariable hazard ratios and 95% confidence intervals (CIs) were calculated for the association between MO3PUFA and disease‐free survival (DFS) and overall survival according to KRAS and BRAFV600E mutations and DNA mismatch repair (MMR) status. Higher MO3PUFA intake was associated with improved 3‐year DFS for KRAS wild‐type tumors (77% vs. 73%; HR: 0.84; 95% CI: 0.67–1.05) but not KRAS‐mutant tumors (64% vs. 70%; HR: 1.30; 95% CI: 0.97–1.73; Pinteraction = 0.02). Similar heterogeneity was found by MMR (Pinteraction = 0.14): higher MO3PUFA was associated with better 3‐year DFS for tumors with deficient MMR (72% vs. 67%) but not proficient MMR (72% vs. 72%). No heterogeneity was found by BRAFV600E mutation. Similar findings were obtained for overall survival. In conclusion, we found a suggestive beneficial association between higher MO3PUFA intake and improved survival among stage III colon cancer patients with wild‐type KRAS and deficient MMR. Given the relatively small number of cases with tumor molecular assessments, further studies, preferably through pooled analyses of multiples cohorts, are needed to validate our findings.
What's new?
Consumption of fish oil or related products containing marine omega‐3 polyunsaturated fatty acid (MO3PUFA) has long been associated with health benefits but effects on cancer survival remain unclear. Here the authors find tentative evidence that MO3PUFA supplementation in patients with stage III colon cancer is associated with better survival, but the benefit was restricted to tumors lacking mutations in the KRAS proto‐oncogene and arising from the microsatellite instability pathway, a finding with possible implications for improving patient care.</description><subject>Aged</subject><subject>Cancer</subject><subject>Cetuximab - therapeutic use</subject><subject>Colon cancer</subject><subject>Colonic Neoplasms - diet therapy</subject><subject>Colonic Neoplasms - drug therapy</subject><subject>Colonic Neoplasms - genetics</subject><subject>Colorectal cancer</subject><subject>Disease-Free Survival</subject><subject>DNA repair</subject><subject>Fatty Acids, Omega-3 - administration & dosage</subject><subject>Female</subject><subject>Fish Oils - administration & dosage</subject><subject>Fluorouracil - therapeutic use</subject><subject>Heterogeneity</subject><subject>Humans</subject><subject>inflammation</subject><subject>Male</subject><subject>Medical research</subject><subject>Microsatellite Instability</subject><subject>Middle Aged</subject><subject>Mismatch repair</subject><subject>Monoclonal antibodies</subject><subject>Mutation</subject><subject>Neoplasm Staging</subject><subject>nutrition</subject><subject>Omega-3 fatty acids</subject><subject>Polyunsaturated fatty acids</subject><subject>Proto-Oncogene Proteins B-raf - genetics</subject><subject>Proto-Oncogene Proteins p21(ras) - genetics</subject><subject>Survival</subject><subject>survivorship care</subject><subject>Targeted cancer therapy</subject><subject>Treatment Outcome</subject><subject>tumor microenvironment</subject><subject>Tumors</subject><issn>0020-7136</issn><issn>1097-0215</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1u1DAURi0EokNhwQsgS2zoIq1_EifZIFURlKBSWJS1dePYU08zdrGdQbPjEVjyfDwJLikVLFhdS_f43E_6EHpOyTElhJ3YjTrmjFL-AK0oaeuCMFo9RKu8I0VNuThAT2LcEEJpRcrH6IATwXjJyAr9-ADBOo39Vq_h57fvHBtIaY9B2RFbl-BaY3AjjnPY2R1M2BscE6w17vseKz95hxU4pUP-onwYrVvj5HGatz7grZ-0mifILwjXOsSsxBddd3mGP11BXCQp2Oy9ILSs8avTabK3uqOn6JGBKepnd_MQfX775rJ7V5x_POu70_NClSXnhRnoaIQ2oNqaD4QMw9BoLlrKRk6h5aY1VTPwmjUNMNMMYqxKxbWiMBImRM0P0evFezMPWz0q7VKASd4EmyPvpQcr_904eyXXfidFxSoi2ix4eScI_susY5IbPweXM0vGmMhZKlpl6mihVPAxBm3uL1Aib0uUuUT5u8TMvvg70j35p7UMnCzAVzvp_f9Nsn_fLcpfvpunSg</recordid><startdate>20190715</startdate><enddate>20190715</enddate><creator>Song, Mingyang</creator><creator>Ou, Fang‐Shu</creator><creator>Zemla, Tyler J.</creator><creator>Hull, Mark A.</creator><creator>Shi, Qian</creator><creator>Limburg, Paul J.</creator><creator>Alberts, Steven R.</creator><creator>Sinicrope, Frank A.</creator><creator>Giovannucci, Edward L.</creator><creator>Van Blarigan, Erin L.</creator><creator>Meyerhardt, Jeffrey A.</creator><creator>Chan, Andrew T.</creator><general>John Wiley & Sons, Inc</general><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TO</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-1324-0316</orcidid></search><sort><creationdate>20190715</creationdate><title>Marine omega‐3 fatty acid intake and survival of stage III colon cancer according to tumor molecular markers in NCCTG Phase III trial N0147 (Alliance)</title><author>Song, Mingyang ; Ou, Fang‐Shu ; Zemla, Tyler J. ; Hull, Mark A. ; Shi, Qian ; Limburg, Paul J. ; Alberts, Steven R. ; Sinicrope, Frank A. ; Giovannucci, Edward L. ; Van Blarigan, Erin L. ; Meyerhardt, Jeffrey A. ; Chan, Andrew T.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4433-fb1df6efac973b00bbb8e36912d31a93f9f58b37288a2f8b6d54c3ec1ad026673</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Cancer</topic><topic>Cetuximab - therapeutic use</topic><topic>Colon cancer</topic><topic>Colonic Neoplasms - diet therapy</topic><topic>Colonic Neoplasms - drug therapy</topic><topic>Colonic Neoplasms - genetics</topic><topic>Colorectal cancer</topic><topic>Disease-Free Survival</topic><topic>DNA repair</topic><topic>Fatty Acids, Omega-3 - administration & dosage</topic><topic>Female</topic><topic>Fish Oils - administration & dosage</topic><topic>Fluorouracil - therapeutic use</topic><topic>Heterogeneity</topic><topic>Humans</topic><topic>inflammation</topic><topic>Male</topic><topic>Medical research</topic><topic>Microsatellite Instability</topic><topic>Middle Aged</topic><topic>Mismatch repair</topic><topic>Monoclonal antibodies</topic><topic>Mutation</topic><topic>Neoplasm Staging</topic><topic>nutrition</topic><topic>Omega-3 fatty acids</topic><topic>Polyunsaturated fatty acids</topic><topic>Proto-Oncogene Proteins B-raf - genetics</topic><topic>Proto-Oncogene Proteins p21(ras) - genetics</topic><topic>Survival</topic><topic>survivorship care</topic><topic>Targeted cancer therapy</topic><topic>Treatment Outcome</topic><topic>tumor microenvironment</topic><topic>Tumors</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Song, Mingyang</creatorcontrib><creatorcontrib>Ou, Fang‐Shu</creatorcontrib><creatorcontrib>Zemla, Tyler J.</creatorcontrib><creatorcontrib>Hull, Mark A.</creatorcontrib><creatorcontrib>Shi, Qian</creatorcontrib><creatorcontrib>Limburg, Paul J.</creatorcontrib><creatorcontrib>Alberts, Steven R.</creatorcontrib><creatorcontrib>Sinicrope, Frank A.</creatorcontrib><creatorcontrib>Giovannucci, Edward L.</creatorcontrib><creatorcontrib>Van Blarigan, Erin L.</creatorcontrib><creatorcontrib>Meyerhardt, Jeffrey A.</creatorcontrib><creatorcontrib>Chan, Andrew T.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Song, Mingyang</au><au>Ou, Fang‐Shu</au><au>Zemla, Tyler J.</au><au>Hull, Mark A.</au><au>Shi, Qian</au><au>Limburg, Paul J.</au><au>Alberts, Steven R.</au><au>Sinicrope, Frank A.</au><au>Giovannucci, Edward L.</au><au>Van Blarigan, Erin L.</au><au>Meyerhardt, Jeffrey A.</au><au>Chan, Andrew T.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Marine omega‐3 fatty acid intake and survival of stage III colon cancer according to tumor molecular markers in NCCTG Phase III trial N0147 (Alliance)</atitle><jtitle>International journal of cancer</jtitle><addtitle>Int J Cancer</addtitle><date>2019-07-15</date><risdate>2019</risdate><volume>145</volume><issue>2</issue><spage>380</spage><epage>389</epage><pages>380-389</pages><issn>0020-7136</issn><eissn>1097-0215</eissn><abstract>Marine omega‐3 polyunsaturated fatty acids (MO3PUFAs) have anticancer properties and may improve colon cancer survival. However, it remains unknown whether the benefit differs by tumor molecular subtype. We examined data from a phase III randomized trial of FOLFOX or FOLFOX + cetuximab among 1,735 stage III colon cancer patients who completed a dietary questionnaire at enrollment. Multivariable hazard ratios and 95% confidence intervals (CIs) were calculated for the association between MO3PUFA and disease‐free survival (DFS) and overall survival according to KRAS and BRAFV600E mutations and DNA mismatch repair (MMR) status. Higher MO3PUFA intake was associated with improved 3‐year DFS for KRAS wild‐type tumors (77% vs. 73%; HR: 0.84; 95% CI: 0.67–1.05) but not KRAS‐mutant tumors (64% vs. 70%; HR: 1.30; 95% CI: 0.97–1.73; Pinteraction = 0.02). Similar heterogeneity was found by MMR (Pinteraction = 0.14): higher MO3PUFA was associated with better 3‐year DFS for tumors with deficient MMR (72% vs. 67%) but not proficient MMR (72% vs. 72%). No heterogeneity was found by BRAFV600E mutation. Similar findings were obtained for overall survival. In conclusion, we found a suggestive beneficial association between higher MO3PUFA intake and improved survival among stage III colon cancer patients with wild‐type KRAS and deficient MMR. Given the relatively small number of cases with tumor molecular assessments, further studies, preferably through pooled analyses of multiples cohorts, are needed to validate our findings.
What's new?
Consumption of fish oil or related products containing marine omega‐3 polyunsaturated fatty acid (MO3PUFA) has long been associated with health benefits but effects on cancer survival remain unclear. Here the authors find tentative evidence that MO3PUFA supplementation in patients with stage III colon cancer is associated with better survival, but the benefit was restricted to tumors lacking mutations in the KRAS proto‐oncogene and arising from the microsatellite instability pathway, a finding with possible implications for improving patient care.</abstract><cop>Hoboken, USA</cop><pub>John Wiley & Sons, Inc</pub><pmid>30623420</pmid><doi>10.1002/ijc.32113</doi><tpages>10</tpages><orcidid>https://orcid.org/0000-0002-1324-0316</orcidid><oa>free_for_read</oa></addata></record> |
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| ispartof | International journal of cancer, 2019-07, Vol.145 (2), p.380-389 |
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| subjects | Aged Cancer Cetuximab - therapeutic use Colon cancer Colonic Neoplasms - diet therapy Colonic Neoplasms - drug therapy Colonic Neoplasms - genetics Colorectal cancer Disease-Free Survival DNA repair Fatty Acids, Omega-3 - administration & dosage Female Fish Oils - administration & dosage Fluorouracil - therapeutic use Heterogeneity Humans inflammation Male Medical research Microsatellite Instability Middle Aged Mismatch repair Monoclonal antibodies Mutation Neoplasm Staging nutrition Omega-3 fatty acids Polyunsaturated fatty acids Proto-Oncogene Proteins B-raf - genetics Proto-Oncogene Proteins p21(ras) - genetics Survival survivorship care Targeted cancer therapy Treatment Outcome tumor microenvironment Tumors |
| title | Marine omega‐3 fatty acid intake and survival of stage III colon cancer according to tumor molecular markers in NCCTG Phase III trial N0147 (Alliance) |
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