Metabolic syndrome is a predictor of all site and liver-specific recurrence following primary resection of colorectal cancer: Prospective cohort study of 1006 patients
Metabolic syndrome is a predictor of all site and liver-specific recurrence following primary resection of colorectal cancer: Prospective cohort study of 1006 patients
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.
Colorectal Cancer, Liver, Metabolic Syndrome, Recurrence, Surgery
1623-1628
Bhome, Rahul
d7b1e0d3-5925-460a-871d-5f52f69c649b
Peppa, Konstantina
be281752-f1bd-4589-94cc-638456c384aa
Karar, Shoura Mohamedelmustafa Ali
6dedf16a-e202-4368-9c35-8709970c009e
McDonnell, Declan
b7499481-73e7-4130-897e-cd4200c8a43b
Mirnezami, Alexander
b3c7aee7-46a4-404c-bfe3-f72388e0bc94
Hamady, Zaed Z R
545a1c81-276e-4341-a420-aa10aa5d8ca8
14 June 2021
Bhome, Rahul
d7b1e0d3-5925-460a-871d-5f52f69c649b
Peppa, Konstantina
be281752-f1bd-4589-94cc-638456c384aa
Karar, Shoura Mohamedelmustafa Ali
6dedf16a-e202-4368-9c35-8709970c009e
McDonnell, Declan
b7499481-73e7-4130-897e-cd4200c8a43b
Mirnezami, Alexander
b3c7aee7-46a4-404c-bfe3-f72388e0bc94
Hamady, Zaed Z R
545a1c81-276e-4341-a420-aa10aa5d8ca8
Bhome, Rahul, Peppa, Konstantina, Karar, Shoura Mohamedelmustafa Ali, McDonnell, Declan, Mirnezami, Alexander and Hamady, Zaed Z R
(2021)
Metabolic syndrome is a predictor of all site and liver-specific recurrence following primary resection of colorectal cancer: Prospective cohort study of 1006 patients.
European Journal of Surgical Oncology, 47 (7), .
(doi:10.1016/j.ejso.2020.12.016).
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.
Text
Bhome et al_20201130_Revised Manuscript_EJSO
- Accepted Manuscript
More information
Accepted/In Press date: 28 December 2020
e-pub ahead of print date: 7 January 2021
Published date: 14 June 2021
Additional Information:
Funding Information:
This work is funded by Southampton NIHR-BRC and a Cancer Research UK grant to ZZH ( C45617/A29908 ). RB is an NIHR funded Clinical Lecturer. The funders had no direct involvement in study design, the collection, analysis and interpretation of data, writing of the report, or decision to submit the article for publication.
Publisher Copyright:
© 2021
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Keywords:
Colorectal Cancer, Liver, Metabolic Syndrome, Recurrence, Surgery
Identifiers
Local EPrints ID: 449209
URI: http://eprints.soton.ac.uk/id/eprint/449209
ISSN: 0748-7983
PURE UUID: c54e5e02-9d2d-44d3-9717-d683a45dc762
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Date deposited: 19 May 2021 18:19
Last modified: 17 Mar 2024 06:23
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Contributors
Author:
Konstantina Peppa
Author:
Shoura Mohamedelmustafa Ali Karar
Author:
Declan McDonnell
Author:
Zaed Z R Hamady
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