title: Preoperative metabolic syndrome and prognosis after radical resection for colorectal cancer: The Fujian prospective investigation of cancer (FIESTA) study.
abstract: This prospective study sought to investigate the prediction of preoperative metabolic syndrome and its components for the risk of colorectal cancer (CRC) mortality by analyzing a subset of data from the ongoing Fujian prospective investigation of cancer (FIESTA) study. In total, 1,318 CRC patients who received radical resection were consecutively enrolled between January 2000 and December 2008. The median follow-up time was 58.6 months, with 412 deaths from CRC. The CRC patients with metabolic syndrome had significantly shorter median survival time (MST) than those without (50.9 vs. 170.3 months, p < 0.001). Among four components of metabolic syndrome, hyperglycemia was the strongest predictor and its presence was associated with shorter MST than its absence (44.4 vs. 170.3 months, p < 0.001). Moreover, the complication of metabolic syndrome in CRC patients was associated with a 2.98-fold increased risk of CRC mortality (hazard ratio [HR] = 2.98, 95% confidence interval [CI]: 2.40-3.69, p < 0.001) after adjusting for confounding factors. The magnitude of this association was especially potentiated in CRC patients with tumor-node-metastasis stage I/II (HR = 3.94, 95% CI: 2.65-5.85, p < 0.001), invasion depth T1/T2 (HR = 5.41, 95% CI: 2.54-11.50, p < 0.001), regional lymph node metastasis N0 (HR = 4.06, 95% CI: 2.85-5.80, p < 0.001) and negative distant metastasis (HR = 3.23, 95% CI: 2.53-4.12, p < 0.001). Further survival tree analysis reinforced the prognostic capability of fasting blood glucose in CRC survival. Our findings convincingly demonstrated that preoperative metabolic syndrome, especially hyperglycemia, was a robust predictor for CRC mortality, and the protection was more obvious in patients with Stage I/II.
authors: Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Feng
authors: F
authors: Peng
authors: Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Dan
authors: D
authors: Hu
authors: Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Xiandong
authors: X
authors: Lin
authors: Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Gang
authors: G
authors: Chen
authors: Medical-Record Department, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Binying
authors: B
authors: Liang
authors: Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Hejun
authors: H
authors: Zhang
authors: State Key Laboratory of Medical Genomics, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Kaida
authors: K
authors: Ji
authors: State Key Laboratory of Medical Genomics, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
authors: Jun
authors: J
authors: Huang
authors: Department of Cardiology, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China.
authors: Jinxiu
authors: J
authors: Lin
authors: Department of Pathology, Fujian Provincial Cancer Hospital, The Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China. niuwenquan_shcn@163.com.
authors: Xiongwei
authors: X
authors: Zheng
authors: State Key Laboratory of Medical Genomics, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China. agu1960@126.com.
authors: Wenquan
authors: W
authors: Niu
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D015179:Colorectal Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications*; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D057234:Preoperative Period; D011379:Prognosis; D011446:Prospective Studies
keywords: colorectal cancer; metabolic syndrome; prognosis; the FIESTA study