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Erschienen in: Indian Journal of Gastroenterology 1/2019

30.01.2019 | Original Article

The metabolic syndrome and its components as prognostic factors in metastatic colorectal cancer

verfasst von: Melissa Reed, Caitlyn Patrick, Brianna Croft, Natalie Walde, Ioannis A. Voutsadakis

Erschienen in: Indian Journal of Gastroenterology | Ausgabe 1/2019

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Abstract

Background

Components of the metabolic syndrome (MetS) are involved in colorectal cancer development and the incidence of the disease is higher in obese and diabetic patients. Nevertheless, the value of these diseases or the MetS as a whole as prognostic markers once colorectal cancer is diagnosed is controversial.

Methods

Patients with metastatic colorectal cancer treated in our center over a 6-year period were reviewed and data on baseline characteristics of the patients and their cancers were extracted. Data on the presence and pharmacologic treatments of the four components of the MetS (obesity, diabetes, hypertension, and dyslipidemia) were also recorded. Overall survival (OS) and progression-free survival (PFS), Kaplan-Meier curves of the various groups were constructed and compared with the log-rank test.

Results

One hundred and twenty-three patients were included in the analysis. The prevalence of the four MetS components was 66.1% for overweight/obesity, 25.2% for diabetes, 61% for hypertension, and 41.5% for dyslipidemia. Among the four components of the metabolic syndrome, none was associated with either PFS or OS. Diabetes tended to approach significance for PFS (p = 0.08). The MetS as a whole did not influence survival outcome. MetS was not prognostic even if the overweight category was not considered as a positive element of the syndrome.

Conclusion

These data suggest that diabetes or other metabolic syndrome elements are not prognostic factors for PFS or OS in metastatic colorectal cancer. Further investigation may be warranted with a focus on refinement of the metabolic evaluation.
Literatur
1.
Zurück zum Zitat Torre LA, Siegel RL, Ward EM, Jemal A. Global cancer incidence and mortality rates and trends- an update. Cancer Epidemiol Biomark Prev. 2016;25:16–27.CrossRef Torre LA, Siegel RL, Ward EM, Jemal A. Global cancer incidence and mortality rates and trends- an update. Cancer Epidemiol Biomark Prev. 2016;25:16–27.CrossRef
2.
Zurück zum Zitat Voutsadakis IA. Pathogenesis of colorectal carcinoma and therapeutic implications: the roles of the ubiquitin-proteasome system and Cox-2. J Cell Mol Med. 2007;11:252–85.CrossRefPubMedPubMedCentral Voutsadakis IA. Pathogenesis of colorectal carcinoma and therapeutic implications: the roles of the ubiquitin-proteasome system and Cox-2. J Cell Mol Med. 2007;11:252–85.CrossRefPubMedPubMedCentral
3.
Zurück zum Zitat Atreya CE, Yaeger R, Chu E. Systemic therapy for metastatic colorectal cancer: from current standards to future molecular targeted approaches. Am Soc Clin Oncol Educ Book. 2017;37:246–56.CrossRefPubMed Atreya CE, Yaeger R, Chu E. Systemic therapy for metastatic colorectal cancer: from current standards to future molecular targeted approaches. Am Soc Clin Oncol Educ Book. 2017;37:246–56.CrossRefPubMed
4.
Zurück zum Zitat Ansary Moghaddam A, Woodward M, Huxley R. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomark Prev. 2007;16:2533–47.CrossRef Ansary Moghaddam A, Woodward M, Huxley R. Obesity and risk of colorectal cancer: a meta-analysis of 31 studies with 70,000 events. Cancer Epidemiol Biomark Prev. 2007;16:2533–47.CrossRef
5.
Zurück zum Zitat Yuhara H, Steinmaus C, Cohen SE, Corley DA, Tei Y, Buffler PA. Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer? Am J Gastroenterol. 2011;106:1911–22.CrossRefPubMedPubMedCentral Yuhara H, Steinmaus C, Cohen SE, Corley DA, Tei Y, Buffler PA. Is diabetes mellitus an independent risk factor for colon cancer and rectal cancer? Am J Gastroenterol. 2011;106:1911–22.CrossRefPubMedPubMedCentral
6.
Zurück zum Zitat Voutsadakis IA. Obesity and diabetes as prognostic factors in patients with colorectal cancer. Diabetes Metab Syndr. 2017;11Suppl 1:S109–14. Voutsadakis IA. Obesity and diabetes as prognostic factors in patients with colorectal cancer. Diabetes Metab Syndr. 2017;11Suppl 1:S109–14.
7.
Zurück zum Zitat Kasi PM, Zafar SY, Grothey A. Is obesity an advantage in patients with colorectal cancer? Expert Rev Gastroenterol Hepatol. 2015;9:1339–42.CrossRefPubMed Kasi PM, Zafar SY, Grothey A. Is obesity an advantage in patients with colorectal cancer? Expert Rev Gastroenterol Hepatol. 2015;9:1339–42.CrossRefPubMed
8.
Zurück zum Zitat Lawrence D, Weigel L, Dale P, Smith B, Honaker MD. Presenting stage in colon cancer is associated with insurance status. Am Surg. 2017;83:728–32.PubMed Lawrence D, Weigel L, Dale P, Smith B, Honaker MD. Presenting stage in colon cancer is associated with insurance status. Am Surg. 2017;83:728–32.PubMed
9.
Zurück zum Zitat Giessen C, Graeven U, Laubender RP et al. Prognostic factors for 60-day mortality in first-line treatment of metastatic colorectal cancer (mCRC): individual patient analysis of four randomized, controlled trials by the AIO colorectal cancer study group. Ann Oncol. 2013;24:3051–5. Giessen C, Graeven U, Laubender RP et al. Prognostic factors for 60-day mortality in first-line treatment of metastatic colorectal cancer (mCRC): individual patient analysis of four randomized, controlled trials by the AIO colorectal cancer study group. Ann Oncol. 2013;24:3051–5.
10.
Zurück zum Zitat Jinjuvadia R, Lohia P, Jinjuvadia C, Montoya S, Liangpunsakul S. The association between metabolic syndrome and colorectal neoplasm. Systemic review and meta-analysis. J Clin Gastroenterol. 2013;47:33–44.CrossRefPubMedPubMedCentral Jinjuvadia R, Lohia P, Jinjuvadia C, Montoya S, Liangpunsakul S. The association between metabolic syndrome and colorectal neoplasm. Systemic review and meta-analysis. J Clin Gastroenterol. 2013;47:33–44.CrossRefPubMedPubMedCentral
11.
Zurück zum Zitat Mills KT, Bellows CF, Hoffman AE, Kelly TN, Gagliardi G. Diabetes mellitus and colorectal cancer prognosis: a meta-analysis. Dis Colon Rectum. 2013;56:1304–19.CrossRefPubMedPubMedCentral Mills KT, Bellows CF, Hoffman AE, Kelly TN, Gagliardi G. Diabetes mellitus and colorectal cancer prognosis: a meta-analysis. Dis Colon Rectum. 2013;56:1304–19.CrossRefPubMedPubMedCentral
12.
Zurück zum Zitat Sinicrope FA, Foster NR, Sargent DJ, O’Connell MJ, Rankin C. Obesity is an independent prognostic variable in colon cancer survivors. Clin Cancer Res. 2010;16:1884–93.CrossRefPubMedPubMedCentral Sinicrope FA, Foster NR, Sargent DJ, O’Connell MJ, Rankin C. Obesity is an independent prognostic variable in colon cancer survivors. Clin Cancer Res. 2010;16:1884–93.CrossRefPubMedPubMedCentral
13.
Zurück zum Zitat Siegel EM, Ulrich CM, Poole EM, Holmes RS, Jacobsen PB, Shibata D. The effects of obesity and obesity-related conditions on colorectal cancer prognosis. Cancer Control. 2010;17:52–7.CrossRefPubMed Siegel EM, Ulrich CM, Poole EM, Holmes RS, Jacobsen PB, Shibata D. The effects of obesity and obesity-related conditions on colorectal cancer prognosis. Cancer Control. 2010;17:52–7.CrossRefPubMed
14.
Zurück zum Zitat Amptoulach S, Gross G, Kalaitzakis E. Differential impact of obesity and diabetes mellitus on survival after liver resection for colorectal cancer metastases. J Surg Res. 2015;199:378–85.CrossRefPubMed Amptoulach S, Gross G, Kalaitzakis E. Differential impact of obesity and diabetes mellitus on survival after liver resection for colorectal cancer metastases. J Surg Res. 2015;199:378–85.CrossRefPubMed
15.
Zurück zum Zitat Renfro LA, Loupakis F, Adams RA et al. Body mass index is prognostic in metastatic colorectal cancer: pooled analysis of patients from first-line clinical trials in the ARCAD database. J Clin Oncol. 2016;34:144–50. Renfro LA, Loupakis F, Adams RA et al. Body mass index is prognostic in metastatic colorectal cancer: pooled analysis of patients from first-line clinical trials in the ARCAD database. J Clin Oncol. 2016;34:144–50.
16.
Zurück zum Zitat Shah MS, Fogelman DR, Singh Raghav KP, et al. Joint prognostic effect of obesity and chronic systemic inflammation in patients with metastatic colorectal cancer. Cancer. 2015;121:2968–75.CrossRefPubMed Shah MS, Fogelman DR, Singh Raghav KP, et al. Joint prognostic effect of obesity and chronic systemic inflammation in patients with metastatic colorectal cancer. Cancer. 2015;121:2968–75.CrossRefPubMed
17.
Zurück zum Zitat Vigneri PG, Tirrò E, Pennisi MS, et al. The insulin/IGF system in colorectal cancer development and resistance to therapy. Front Oncol. 2015;5:230.CrossRefPubMedPubMedCentral Vigneri PG, Tirrò E, Pennisi MS, et al. The insulin/IGF system in colorectal cancer development and resistance to therapy. Front Oncol. 2015;5:230.CrossRefPubMedPubMedCentral
Metadaten
Titel
The metabolic syndrome and its components as prognostic factors in metastatic colorectal cancer
verfasst von
Melissa Reed
Caitlyn Patrick
Brianna Croft
Natalie Walde
Ioannis A. Voutsadakis
Publikationsdatum
30.01.2019
Verlag
Springer India
Erschienen in
Indian Journal of Gastroenterology / Ausgabe 1/2019
Print ISSN: 0254-8860
Elektronische ISSN: 0975-0711
DOI
https://doi.org/10.1007/s12664-018-0923-0

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