Preoperative metabolic syndrome and prognosis after radical resection for colorectal cancer: The Fujian prospective investigation of cancer (FIESTA) study. Issue 12 (15th September 2016)

• Record Type: Journal Article
• Authors: Peng, Feng; Hu, Dan; Lin, Xiandong; Chen, Gang; Liang, Binying; Zhang, Hejun; Ji, Kaida; Huang, Jun; Lin, Jinxiu; Zheng, Xiongwei; Niu, Wenquan
• Is Part Of: International journal of cancer. Volume 139:Issue 12(2016:Dec. 15)
• Page Start: 2705
• Page End: 2713
• Publication Date: 2016-09-15
• Subjects: colorectal cancer -- metabolic syndrome -- the FIESTA study -- prognosis; Cancer -- Periodicals; Cancer -- Prevention -- Periodicals; 616.994
• DOI: 10.1002/ijc.30404
• Languages: English
• ISSNs: 0020-7136

Abstract

Abstract : This prospective study sought to investigate the prediction of preoperative metabolic syndrome and its components for the risk of colorectal cancer (CRC) mortality by analyzing a subset of data from the ongoing Fujian prospective investigation of cancer (FIESTA) study. In total, 1, 318 CRC patients who received radical resection were consecutively enrolled between January 2000 and December 2008. The median follow‐up time was 58.6 months, with 412 deaths from CRC. The CRC patients with metabolic syndrome had significantly shorter median survival time (MST) than those without (50.9 vs . 170.3 months, p < 0.001). Among four components of metabolic syndrome, hyperglycemia was the strongest predictor and its presence was associated with shorter MST than its absence (44.4 vs . 170.3 months, p < 0.001). Moreover, the complication of metabolic syndrome in CRC patients was associated with a 2.98‐fold increased risk of CRC mortality (hazard ratio [HR] = 2.98, 95% confidence interval [CI]: 2.40–3.69, p < 0.001) after adjusting for confounding factors. The magnitude of this association was especially potentiated in CRC patients with tumor‐node‐metastasis stage I/II (HR = 3.94, 95% CI: 2.65–5.85, p < 0.001), invasion depth T1/T2 (HR = 5.41, 95% CI: 2.54–11.50, p < 0.001), regional lymph node metastasis N0 (HR = 4.06, 95% CI: 2.85‐5.80, p < 0.001) and negative distant metastasis (HR = 3.23, 95% CI: 2.53–4.12, p < 0.001). Further survival tree analysis reinforced the prognostic capability of fasting blood glucose in CRC survival. Our findings convincingly demonstrated that preoperative metabolic syndrome, especially hyperglycemia, was a robust predictor for CRC mortality, and the protection was more obvious in patients with Stage I/II. Abstract : What's new? Clinical observations suggest that metabolic syndrome may be a prognostic risk factor for colorectal cancer (CRC) survival. While a better understanding of the contribution of single metabolic abnormalities to poor prognosis could lead to better clinical management, data remain sparse. This prospective study investigated the prognostic value of preoperative metabolic syndrome and related abnormalities for CRC mortality among 1, 318 patients with a median follow‐up of 58.6 months. Preoperative metabolic syndrome, especially hyperglycemia, was a robust predictor for CRC mortality, highlighting early targeted control of metabolic abnormalities as a potentially effective intervention to improve the prognosis and survival of CRC patients.