Effect of Preoperative Inflammatory Diet on Clinical and Oncologic Outcomes Following Colorectal Cancer Surgery.

Objectives

The dietary inflammatory index (DII), a validated tool for assessing the inflammatory potential of diet, has been widely identified as a significant risk factor for colorectal cancer (CRC). However, its role as a prognostic factor for CRC remains unexplored. This study examined the impact of preoperative dietary inflammation on clinical and oncologic outcomes following CRC surgery.

Methods

The study population consisted of 126 patients who had surgical procedures for CRC and completed a food frequency questionnaire (FFQ) preoperatively between January 2018 and June 2020.

Results

An optimal DII cut-off value of 0.90182 was used to categorize patients into the high-DII (n = 28) and low-DII (n = 98) groups. The high-DII group exhibited an older age (71.5 vs. 67.0, p = 0.020) and a significantly higher complication risk within 30 days postoperatively than the low-DII group (57.1% vs. 35.7%, p = 0.042). Other perioperative clinical outcomes did not demonstrate any significant differences between the two groups. The 5-year overall survival (OS) rates were 90.4% and 41.3% in the low-DII and high-DII groups, respectively, in univariate survival analysis (p = 0.044). However, no statistical difference was observed in the disease-free survival (DFS) rate. In the multivariate survival analysis, low-DII (hazard ratio [HR]: 0.118; 95% confidence interval [CI]: 0.023-0.613, p = 0.011) and M1 stage (HR: 10.910; 95% CI: 1.491-79.847, p = 0.019) were identified as independent prognostic factors for OS, while perineural invasion (HR: 3.495; 95% CI: 1.059-11.533, p = 0.040) served as an independent prognostic factor for DFS.

Conclusions

A high preoperative DII score, indicative of an inflammatory dietary pattern, was correlated with increased postoperative complications and functioned as an independent prognostic indicator for OS.