Role of circadian rhythm disruption and dietary polyphenols in the prognosis of neoadjuvant therapy for locally advanced colorectal cancer.

OBJECTIVE

To explore the influence of circadian rhythm disruption and dietary polyphenols on the prognosis of neoadjuvant therapy in patients with locally advanced colorectal cancer (CRC).

METHODS

A retrospective case-control study was conducted involving 262 patients with locally advanced CRC who received neoadjuvant therapy. Patients were categorized into good prognosis (n = 121) and poor prognosis (n = 141) groups based on Tumor Regression Grading. Data collected included demographic characteristics, work schedules, dietary intake, blood biomarkers, circadian rhythm assessments, and sleep quality metrics. Statistical analyses included chi-square tests, Pearson and Spearman correlations, and Receiver Operating Characteristic curve analysis to identify significant prognostic indicators.

RESULTS

Favorable prognostic factors included younger age, better Eastern Cooperative Oncology Group performance status, lower Tumor-Node-Metastasis stage, absence of night shift work, regular work schedules, and greater exposure to natural light. Higher dietary polyphenol intake - primarily from fruits, vegetables, and plant-based foods - was significantly associated with improved treatment response. In contrast, disrupted cortisol rhythms and poor sleep quality predicted worse outcomes. Total polyphenol intake demonstrated strong predictive power (Area Under the Curve [AUC] = 0.847), as did cortisol rhythm disruption (AUC = 0.810).

CONCLUSION

Stability of circadian rhythms and higher dietary polyphenol intake were associated with improved responses to neoadjuvant therapy in patients with locally advanced CRC.