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

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.

Diabetes, Obesity, and the Metabolic Syndrome as Prognostic Factors in Stages I to III Colorectal Cancer Patients.

BACKGROUND: Attempts to introduce prognostic factors for survival outcomes in localized colorectal cancer patients receiving surgical treatment with or without adjuvant therapies, beyond the classic staging parameters, have been met with limited success. Obesity and diabetes mellitus are among the conditions that predispose to colorectal cancer but their value as prognostic markers once the disease is diagnosed is controversial. PATIENTS AND METHODS: This study examines the prognostic value of the components of metabolic syndrome in a retrospective series of colorectal cancer patients with stages I to III disease followed in a single center. RESULTS: Among the four components of the metabolic syndrome, only diabetes was independently associated with progression-free survival (PFS) while obesity, hypertension, and dyslipidemia were not. No associations of the metabolic syndrome (MS) or its components with overall survival (OS) were observed in multivariate analysis. CONCLUSION: These data pinpoint to diabetes mellitus (DM) as a possible prognostic factor for PFS in localized colorectal cancer and further cast doubt for the value of obesity as measured by body mass index (BMI) on local stage colorectal cancer prognosis.