Body mass index-based predictions and personalized clinical strategies for colorectal cancer in the context of PPPM.
Body mass index-based predictions and personalized clinical strategies for colorectal cancer in the context of PPPM.
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DOI：
10.1007/s13167-022-00306-0
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发表时间：
2022-12
期刊：
影响因子：
--
通讯作者：
Wu LY
中科院分区：
文献类型：
--
作者：
Gu YJ;Chen LM;Gu ME;Xu HX;Li J;Wu LY
目前，结直肠癌（CRC）是全球第三大常见癌症。体重指数 (BMI) 经常用于 CRC 筛查和风险评估，以定量评估体重。然而，BMI 对 CRC 临床策略的影响却很少受到关注。在预测、预防和个性化医疗 (3PM/PPPM) 的框架内，我们假设 BMI 分层会影响 CRC 的初级、二级和三级护理选择，并进行了一项重要的循证审查。 BMI 动态影响 CRC 的结果，这有助于避免不良的治疗效果。超重（BMI ≥ 30）或体重不足（BMI < 20）会对手术和放射治疗的结果产生不利影响。许多干预措施，例如加速康复外科和机器人手术，可应用于所有 BMI 水平的结直肠癌。运动、饮食控制、营养治疗和药物等体重指数控制方式可能对结直肠癌患者有益。建议超重患者通过饮食、药物和体力活动来减肥，而体重过轻的患者则需要更多关注营养。 BMI 可帮助 CRC 患者更好地管理体重，从而降低治疗期间不良预后事件的发生率。 BMI 易于获取、无创且高度预测 CRC 的临床结果。通过推广基于 BMI 的 CRC 临床策略模型，可以提高发展中国家 PPPM 范式的成本效益，并提高患者的临床获益。
Currently colorectal cancer (CRC) is the third most prevalent cancer worldwide. Body mass index (BMI) is frequently used in CRC screening and risk assessment to quantitatively evaluate weight. However, the impact of BMI on clinical strategies for CRC has received little attention. Within the framework of the predictive, preventive, and personalized medicine (3PM/PPPM), we hypothesized that BMI stratification would affect the primary, secondary, and tertiary care options for CRC and we conducted a critical evidence-based review. BMI dynamically influences CRC outcomes, which helps avoiding adverse treatment effects. The outcome of surgical and radiation treatment is adversely affected by overweight (BMI ≥ 30) or underweight (BMI < 20). A number of interventions, such as enhanced recovery after surgery and robotic surgery, can be applied to CRC at all levels of BMI. BMI-controlling modalities such as exercise, diet control, nutritional therapy, and medications may be potentially beneficial for patients with CRC. Patients with overweight are advised to lose weight through diet, medication, and physical activity while patients suffering of underweight require more focus on nutrition. BMI assists patients with CRC in better managing their weight, which decreases the incidence of adverse prognostic events during treatment. BMI is accessible, noninvasive, and highly predictive of clinical outcomes in CRC. The cost–benefit of the PPPM paradigm in developing countries can be advanced, and the clinical benefit for patients can be improved with the promotion of BMI-based clinical strategy models for CRC.
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