title: The impact of metabolic syndrome on outcome and response to neoadjuvant chemoradiation in locally advanced rectal cancer patients.
abstract: OBJECTIVE
  Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors shown to increase the risk of developing various malignancies, as well as diminish tumor response to conventional therapies. The effects of MetS and its individual components on therapeutic response and treatment-related outcomes were examined in patients with locally advanced rectal cancer (LARC).
  
  
  METHODS
  Data was retrospectively collected on LARC patients treated with neoadjuvant chemoradiation (nCRT) and surgery. Medical records were reviewed for patient characteristics, staging, treatment plan, and outcomes.
  
  
  RESULTS
  One hundred two patients were included in the study. Patients with HTN had a significantly decreased nCRT response and were four times more likely to experience a poor response to treatment compared to patients without HTN. Additionally, HTN was found to significantly increase the rate of surgical complications. Neither DM nor obesity exhibited any significant effect on therapeutic response or complication rates, either individually or in combination with another risk factor.
  
  
  CONCLUSIONS
  This study demonstrates the importance of considering underlying MetS risk factors, especially HTN, when predicting tumor response in LARC patients undergoing nCRT followed by radical surgery. The results provide support for an increased focus on pre-treatment risk factor control to optimize cancer therapy outcomes.
authors.affiliation: Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA.
authors.forename: Brandon J
authors.initials: BJ
authors.lastname: Anderson
authors.affiliation: Department of Public Health Sciences, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA.
authors.forename: Amy E
authors.initials: AE
authors.lastname: Wahlquist
authors.affiliation: Department of Public Health Sciences, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA.
authors.forename: Elizabeth G
authors.initials: EG
authors.lastname: Hill
authors.affiliation: Department of Radiation Oncology, Charleston, SC 29425, USA.
authors.forename: David T
authors.initials: DT
authors.lastname: Marshall
authors.affiliation: Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, Charleston, SC 29425, USA.
authors.forename: Eric T
authors.initials: ET
authors.lastname: Kimchi
authors.affiliation: Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, Charleston, SC 29425, USA.
authors.forename: Kevin F
authors.initials: KF
authors.lastname: Staveley O'Carroll
authors.affiliation: Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA; Ralph H. Johnson VA Medical Center, Charleston, SC 29425, USA. Electronic address: campe@musc.edu.
authors.forename: E Ramsay
authors.initials: ER
authors.lastname: Camp
mesh_terms: D059248:Chemoradiotherapy; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology*; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D012004:Rectal Neoplasms / Q000453:epidemiology* / Q000601:surgery / Q000628:therapy*; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome
keywords: Chemoradiation; Diabetes; Hypertension; Metabolic syndrome; Neoadjuvant; Obesity; Rectal cancer