Enterolactone concentrations and prognosis after postmenopausal breast cancer: assessment of effect modification and meta-analysis
- Link:
- Autor/in:
- Erscheinungsjahr:
- 2014
- Medientyp:
- Text
- Schlagworte:
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- dk/atira/pure/publikationen_lom_relevant/cancer
- Cancer Medicine – University Cancer Center Hamburg (UCCH)
- 4-Butyrolactone
- Aged
- Body Mass Index
- Breast Neoplasms
- Diet
- Disease Progression
- Disease-Free Survival
- Female
- Germany
- Humans
- Life Style
- Lignans
- Middle Aged
- Postmenopause
- Prognosis
- Proportional Hazards Models
- Prospective Studies
- Risk Factors
- Tumor Markers, Biological
- dk/atira/pure/keywords/workgroup/141
- AG Epidemiologie (141)
- Beschreibung:
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We previously reported that high concentrations of enterolactone, a lignan metabolite, are associated with lower mortality in 1,140 breast cancer patients from Germany. Using an extended set of 2,182 patients aged 50-74 years at diagnosis (2001-2005) and prospectively followed up until 2009, we investigated whether the association with mortality differs by lifestyle factors and tumor characteristics. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using multivariable Cox regression. Potential differential effects by tumor characteristics and lifestyle factors were assessed and a meta-analysis of five studies addressing lignan exposure and breast cancer prognosis was performed to summarize evidence. Median enterolactone concentrations were 17.4 (± 30.5 standard deviation) and 22.9 nmol L(-1) (± 44.8), respectively, for 269 deceased and 1,913 patients still alive. High enterolactone concentrations were significantly associated with lower all-cause mortality (per 10 nmol L(-1) : HR 0.94, 95% CI 0.90-0.98), breast cancer-specific mortality (HR 0.94, 0.89-0.99), and distant disease-free survival (HR 0.94, 0.90-0.98). Associations were found for stage 0-IIIA but not for stage IIIB-IV disease (p(het) = 0.01) and were stronger in patients with BMI <25 kg m(-2) than those with BMI ≥ 25 (p(het) = 0.04). In patients with healthy lifestyle (BMI <25, nonsmoker, physically active), the inverse association with all-cause mortality was still apparent (HR 0.92, 0.85-0.99). The meta-analysis yielded significant associations both for all-cause (HR 0.57, 0.42-0.78) and breast cancer-specific mortality (HR 0.54, 0.39-0.75). Our findings show that high lignan exposure is associated with reduced mortality in breast cancer patients. The inverse association observed in this study cannot be entirely explained by a healthy lifestyle.
- Lizenz:
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- info:eu-repo/semantics/restrictedAccess
- Quellsystem:
- Forschungsinformationssystem des UKE
Interne Metadaten
- Quelldatensatz
- oai:pure.atira.dk:publications/a5581209-38c8-4315-a15e-901c0183fb4d