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Metabolic syndrome did not impact colon cancer survival, recurrence
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Metabolic syndrome did not affect survival or recurrence rates among patients with colon cancer, while diabetes, hypertension and elevated glucose levels had a negative impact in a recent study.
In a retrospective cohort study, researchers evaluated data from 36,079 patients aged 66 years or older with colon cancer collected from the SEER-Medicare linked database. The impact of metabolic syndrome (MetS) and its components on overall survival and cancer recurrence following treatment was assessed. MetS was defined as the presence of three or more of the five components of the ATP III definition of the illness on two or more Medicare claims filed more than 30 days apart.
MetS was observed in 19.5% of participants, of which 30.4% had elevated glucose levels/diabetes mellitus (DM), 75.9% had hypertension, 50% had dyslipidemia, 4.3% were obese and 1.4% had hypertriglyceridemia.
After controlling for other factors, no association was observed between MetS and colon cancer survival, both overall (adjusted HR=0.98; 95% CI, 0.93-1.02) or after stratification by stage. MetS also was not associated with recurrence-free rate among those with stage I, II or III cancer, before (aHR=1.01; 95% CI, 0.93-1.10) and after stratification.
Elevated glucose levels and DM were associated with worse survival (aHR=1.17; 95% CI, 1.13-1.21), as was hypertension (aHR=1.08; 95% CI, 1.03-1.12). Both conditions were associated with increased recurrence (aHR=1.25; 95% CI, 1.16-1.34 for glucose/DM and aHR=1.22; 95% CI, 1.12-1.33 for hypertension) among patients with stages I, II or III colon cancer. After stratifying by stage, associations persisted only in early-stage cancer.
Investigators noted associations across all stages between dyslipidemia and improved survival (aHR=0.77; 95% CI, 0.75-.080) and reduced risk for recurrence (aHR=0.71; 95% CI, 0.66-0.75).
“There is no apparent association between MetS and survival in patients with colon cancer, likely because of the combined, independent adverse effects of blood glucose/DM and hypertension, and the protective effect of dyslipidemia in patients with nonmetastatic disease,” the researchers wrote. “Additional studies … are needed. In the interim, patients with elevated glucose/DM or hypertension and nonmetastatic colon cancer perhaps should be considered for more intense cancer surveillance and/or broader use of adjuvant chemotherapy.”
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