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.