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. 2021 Jul;47(7):1623-1628.
doi: 10.1016/j.ejso.2020.12.016. Epub 2021 Jan 7.

Metabolic syndrome is a predictor of all site and liver-specific recurrence following primary resection of colorectal cancer: Prospective cohort study of 1006 patients

Rahul Bhome  1 , Nadia Peppa  1 , Shoura Karar  2 , Declan McDonnell  2 , Alex Mirnezami  3 , Zaed Hamady  4
Affiliations

Metabolic syndrome is a predictor of all site and liver-specific recurrence following primary resection of colorectal cancer: Prospective cohort study of 1006 patients

Rahul Bhome et al. Eur J Surg Oncol. 2021 Jul.

Abstract

Introduction: Large epidemiological studies have demonstrated the link between metabolic syndrome and cancer development, including colorectal cancer. However, the influence of metabolic syndrome on disease progression is less well studied, particularly in the post-surgical setting. This study investigates the effect of metabolic syndrome on colorectal cancer recurrence (all-site and liver-specific) after curative surgery for Stage I-III disease.

Materials and methods: Consecutive patients who underwent curative resection for Stage I-III colorectal cancer in a single UK centre were prospectively recruited. Disease-free and overall survival with metabolic syndrome as a factor, were determined using the Kaplan-Meier technique. Hazard ratios for all-site and liver-specific recurrence were determined using univariable and multivariable Cox-regression models.

Results: 1006 patients were recruited and followed up for a median of 50 months (IQR 30-67). 177 patients (17.6%) met the criteria for metabolic syndrome. 245 patients (25.4%) developed recurrence, 161 (16.0%) of these had liver recurrence. The presence of metabolic syndrome was associated with a reduction in disease-free survival from 69 to 58 months (p < 0.001) and overall survival from 74 to 61 months (p < 0.001). Metabolic syndrome was an independent predictor of all-site (HR 1.76; p < 0.001) and liver-specific (HR 1.74; p = 0.01) recurrence.

Conclusion: Metabolic syndrome is a predictor of all-site and liver-specific recurrence after primary resection of stage I-III colorectal cancer.

Keywords: Colorectal Cancer; Liver; Metabolic Syndrome; Recurrence; Surgery.

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Conflict of interest statement

Declaration of competing interest The authors report no competing interests.

Figures

Figure 1
Figure 1. The effect of MetS on DFS and OS following curative resection.
Kaplan-Meir curves for the effect of MetS on (A) DFS and (B) OS following curative primary colorectal resection. Number at risk provided in tables. Log rank test used to derive p values.
See this image and copyright information in PMC

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