title: Metabolic syndrome contributes to an increased recurrence risk of non-metastatic colorectal cancer.
abstract: OBJECTIVE
  Epidemiological data suggests a close link between metabolic syndrome (MetS) and non-metastatic colorectal cancer (NMCRC). However, the relationship between MetS and the outcome of NMCRC is less well understood. We aim to evaluate the impact of MetS on the prognosis in NMCRC patients.
  
  
  METHODS
  We performed a large cohort study of 1069 NMCRC patients. The Kaplan-Meier method was used to calculate the cumulative survival rate. Cox proportional hazard regression models were used to analyze the prognosis associated with MetS adjusting for clinicopathologic variables.
  
  
  RESULTS
  MetS was identified in 20.7% of NMCRC patients. Patients with MetS were more likely to be older, higher levels of blood glucose, triglycerides, high density lipoprotein, and uric acid than patients without MS (P < 0.05 for all). During a mean period of 59.6 months follow-up, patients with MetS had a statistically significantly lower rate of disease-free survival (DFS) than the patients without MetS (P = 0.014), especially local recurrence (P = 0.040). However, there was no difference in overall survival (P = 0.116). Multivariate analysis showed that the presence of MetS was an independent risk factor for DFS (HR = 0.733, 95%CI 0.545-0.987, P = 0.041), but not for OS (P = 0.118).
  
  
  CONCLUSIONS
  MetS is associated with an increased recurrence risk of NMCRC.
authors.affiliation: Department of Oncological Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Jie
authors.initials: J
authors.lastname: You
authors.affiliation: Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Wen-Yue
authors.initials: WY
authors.lastname: Liu
authors.affiliation: Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.|School of the First Clinical Medical Sciences, Wenzhou Medical University, Wenzhou, China.
authors.forename: Gui-Qi
authors.initials: GQ
authors.lastname: Zhu
authors.affiliation: Department of Oncological Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Ou-Chen
authors.initials: OC
authors.lastname: Wang
authors.affiliation: Department of Oncological Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Rui-Min
authors.initials: RM
authors.lastname: Ma
authors.affiliation: Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.|Renji School of Wenzhou Medical University, Wenzhou, China.
authors.forename: Gui-Qian
authors.initials: GQ
authors.lastname: Huang
authors.affiliation: Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.|Institute of Hepatology, Wenzhou Medical University, Wenzhou, China.
authors.forename: Ke-Qing
authors.initials: KQ
authors.lastname: Shi
authors.affiliation: Department of Oncological Surgery, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
authors.forename: Gui-Long
authors.initials: GL
authors.lastname: Guo
authors.affiliation: Global Medicines Development, AstraZeneca R&D, Alderley Park, United Kingdom.
authors.forename: Martin
authors.initials: M
authors.lastname: Braddock
authors.affiliation: Department of Infection and Liver Diseases, Liver Research Center, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.|Institute of Hepatology, Wenzhou Medical University, Wenzhou, China.
authors.forename: Ming-Hua
authors.initials: MH
authors.lastname: Zheng
mesh_terms: D000368:Aged; D016009:Chi-Square Distribution; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
keywords: disease-free survival; metabolic syndrome; non-metastatic colorectal cancer; overall survival; risk factor