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

J Gastrointest Cancer. 2019 Jun;50(2):221-229. doi: 10.1007/s12029-018-0056-9.

Abstract

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.

Keywords: Body weight; Colon; Diabetes; Hypertension; Metabolic syndrome; Obesity; Overall survival; Progression-free survival; Rectal.

MeSH terms

  • Aged
  • Body Mass Index
  • Colorectal Neoplasms / mortality
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / physiopathology
  • Colorectal Neoplasms / surgery
  • Diabetes Complications / pathology*
  • Diabetes Complications / physiopathology
  • Disease-Free Survival
  • Female
  • Humans
  • Male
  • Metabolic Syndrome / pathology*
  • Metabolic Syndrome / physiopathology
  • Neoplasm Staging
  • Obesity / pathology*
  • Obesity / physiopathology
  • Prognosis
  • Retrospective Studies
  • Survival Rate