Effect of metabolic syndrome and its components on recurrence and survival in colon cancer patients
BACKGROUND: Although epidemiologic studies suggest that metabolic syndrome (MetS) increases the risk of colorectal cancer, its effect on cancer mortality remains controversial. METHODS: The authors used the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database (1998‐2006) to co...
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| Veröffentlicht in: | Cancer 2013-04, Vol.119 (8), p.1512-1520 |
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| creator | Yang, Yang Mauldin, Patrick D. Ebeling, Myla Hulsey, Thomas C. Liu, Baorui Thomas, Melanie B. Camp, Ernest R. Esnaola, Nestor F. |
| description | BACKGROUND:
Although epidemiologic studies suggest that metabolic syndrome (MetS) increases the risk of colorectal cancer, its effect on cancer mortality remains controversial.
METHODS:
The authors used the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database (1998‐2006) to conduct a retrospective cohort study of 36,079 patients with colon cancer to determine the independent effect of MetS and its components on overall survival (OS) and recurrence‐free rates (RFRs). Data on MetS and its components were ascertained from Medicare claims. OS and RFRs in patients with and without MetS and its components were compared using multivariate Cox models.
RESULTS:
MetS had no apparent effect on OS or RFR. Both elevated glucose/diabetes mellitus (DM) and elevated hypertension were associated with worse OS (adjusted hazard ratio [aHR], 1.17 [95% confidence interval, 1.13‐1.21] and 1.08 [95% confidence interval, 1.03‐1.12], respectively) and worse RFRs (aHR, 1.25 [95% confidence interval, 1.16‐1.34] and 1.22 [95% confidence interval, 1.12‐1.33], respectively). In contrast, dyslipidemia was associated with improved survival (aHR, 0.77; 95% confidence interval, 0.75‐0.80) and reduced recurrence (aHR, 0.71; 95% confidence interval, 0.66‐0.75). These effects were consistent for both men and women and were more pronounced in patients with early stage disease.
CONCLUSIONS:
MetS had no apparent effect on colon cancer outcomes, probably because of the combined adverse effects of elevated glucose/DM and hypertension and the protective effect of dyslipidemia in patients with nonmetastatic disease. The authors concluded that patients who have early stage colon cancer with elevated glucose/DM and/or hypertension may benefit from more intensive surveillance and/or broader use of adjuvant therapy and that trials to define the benefits of low‐fat diets, insulin‐lowering agents, and statins on recurrence/survival in patients with nonmetastatic colon cancer are warranted. Cancer 2013. © 2012 American Cancer Society.
Metabolic syndrome has no apparent effect on colon cancer outcomes. This effect probably is attributable to the combined adverse effects of elevated glucose/diabetes mellitus and hypertension and the protective effect of dyslipidemia in patients with nonmetastatic disease. |
| doi_str_mv | 10.1002/cncr.27923 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1325331099</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>1325331099</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3953-710583d1e7b1b403865ddb5dcf5a59a29d509f64ced0b9df4d3c804adb9b84fe3</originalsourceid><addsrcrecordid>eNp90F1LwzAUBuAgipvTG3-A5EYQoTNpmrW5lDI_QBREwbuS5gMiaTKTdrJ_b2an3nmVhPPkHM4LwClGc4xQfiWcCPO8ZDnZA1OMWJkhXOT7YIoQqjJakLcJOIrxPT3LnJJDMMlJXiFCyBSIpdZK9NBr2Kmet94aAePGyeA7BbmT0PQRCt-tvFMuXb2DQYkhBOXECOIQ1mbNLTQuQZuA4KkW4Ir3ZvvnGBxobqM62Z0z8HqzfKnvsoen2_v6-iEThFGSlRjRikisyha3BSLVgkrZUik05ZTxnEmKmF4UQknUMqkLSUSFCi5b1laFVmQGLsa-q-A_BhX7pjNRKGu5U36IDSZpe5ICYolejlQEH2NQulkF0_GwaTBqtqE221Cb71ATPtv1HdpOyV_6k2IC5zvAo-BWh7S_iX-uxKxI0SeHR_dprNr8M7KpH-vncfgXWM2QSA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1325331099</pqid></control><display><type>article</type><title>Effect of metabolic syndrome and its components on recurrence and survival in colon cancer patients</title><source>Wiley Free Content</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>EZB-FREE-00999 freely available EZB journals</source><source>Alma/SFX Local Collection</source><creator>Yang, Yang ; Mauldin, Patrick D. ; Ebeling, Myla ; Hulsey, Thomas C. ; Liu, Baorui ; Thomas, Melanie B. ; Camp, Ernest R. ; Esnaola, Nestor F.</creator><creatorcontrib>Yang, Yang ; Mauldin, Patrick D. ; Ebeling, Myla ; Hulsey, Thomas C. ; Liu, Baorui ; Thomas, Melanie B. ; Camp, Ernest R. ; Esnaola, Nestor F.</creatorcontrib><description>BACKGROUND:
Although epidemiologic studies suggest that metabolic syndrome (MetS) increases the risk of colorectal cancer, its effect on cancer mortality remains controversial.
METHODS:
The authors used the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database (1998‐2006) to conduct a retrospective cohort study of 36,079 patients with colon cancer to determine the independent effect of MetS and its components on overall survival (OS) and recurrence‐free rates (RFRs). Data on MetS and its components were ascertained from Medicare claims. OS and RFRs in patients with and without MetS and its components were compared using multivariate Cox models.
RESULTS:
MetS had no apparent effect on OS or RFR. Both elevated glucose/diabetes mellitus (DM) and elevated hypertension were associated with worse OS (adjusted hazard ratio [aHR], 1.17 [95% confidence interval, 1.13‐1.21] and 1.08 [95% confidence interval, 1.03‐1.12], respectively) and worse RFRs (aHR, 1.25 [95% confidence interval, 1.16‐1.34] and 1.22 [95% confidence interval, 1.12‐1.33], respectively). In contrast, dyslipidemia was associated with improved survival (aHR, 0.77; 95% confidence interval, 0.75‐0.80) and reduced recurrence (aHR, 0.71; 95% confidence interval, 0.66‐0.75). These effects were consistent for both men and women and were more pronounced in patients with early stage disease.
CONCLUSIONS:
MetS had no apparent effect on colon cancer outcomes, probably because of the combined adverse effects of elevated glucose/DM and hypertension and the protective effect of dyslipidemia in patients with nonmetastatic disease. The authors concluded that patients who have early stage colon cancer with elevated glucose/DM and/or hypertension may benefit from more intensive surveillance and/or broader use of adjuvant therapy and that trials to define the benefits of low‐fat diets, insulin‐lowering agents, and statins on recurrence/survival in patients with nonmetastatic colon cancer are warranted. Cancer 2013. © 2012 American Cancer Society.
Metabolic syndrome has no apparent effect on colon cancer outcomes. This effect probably is attributable to the combined adverse effects of elevated glucose/diabetes mellitus and hypertension and the protective effect of dyslipidemia in patients with nonmetastatic disease.</description><identifier>ISSN: 0008-543X</identifier><identifier>EISSN: 1097-0142</identifier><identifier>DOI: 10.1002/cncr.27923</identifier><identifier>PMID: 23280333</identifier><identifier>CODEN: CANCAR</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Aged ; Aged, 80 and over ; Biological and medical sciences ; Cohort Studies ; colon cancer ; Colonic Neoplasms - epidemiology ; Colonic Neoplasms - metabolism ; Colonic Neoplasms - mortality ; Colonic Neoplasms - pathology ; diabetes mellitus ; dyslipidemia ; elevated glucose ; Female ; Humans ; hypertension ; Male ; Medical sciences ; Metabolic diseases ; metabolic syndrome ; Metabolic Syndrome - epidemiology ; Metabolic Syndrome - metabolism ; Metabolic Syndrome - pathology ; Miscellaneous ; Neoplasm Recurrence, Local - epidemiology ; Neoplasm Recurrence, Local - metabolism ; Neoplasm Recurrence, Local - mortality ; Neoplasm Recurrence, Local - pathology ; Other metabolic disorders ; recurrence ; Retrospective Studies ; Risk Factors ; SEER Program ; survival ; Survival Rate ; Treatment Outcome ; Tumors ; United States - epidemiology</subject><ispartof>Cancer, 2013-04, Vol.119 (8), p.1512-1520</ispartof><rights>Copyright © 2012 American Cancer Society</rights><rights>2014 INIST-CNRS</rights><rights>Copyright © 2012 American Cancer Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3953-710583d1e7b1b403865ddb5dcf5a59a29d509f64ced0b9df4d3c804adb9b84fe3</citedby><cites>FETCH-LOGICAL-c3953-710583d1e7b1b403865ddb5dcf5a59a29d509f64ced0b9df4d3c804adb9b84fe3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1002%2Fcncr.27923$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1002%2Fcncr.27923$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=27194072$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23280333$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Yang, Yang</creatorcontrib><creatorcontrib>Mauldin, Patrick D.</creatorcontrib><creatorcontrib>Ebeling, Myla</creatorcontrib><creatorcontrib>Hulsey, Thomas C.</creatorcontrib><creatorcontrib>Liu, Baorui</creatorcontrib><creatorcontrib>Thomas, Melanie B.</creatorcontrib><creatorcontrib>Camp, Ernest R.</creatorcontrib><creatorcontrib>Esnaola, Nestor F.</creatorcontrib><title>Effect of metabolic syndrome and its components on recurrence and survival in colon cancer patients</title><title>Cancer</title><addtitle>Cancer</addtitle><description>BACKGROUND:
Although epidemiologic studies suggest that metabolic syndrome (MetS) increases the risk of colorectal cancer, its effect on cancer mortality remains controversial.
METHODS:
The authors used the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database (1998‐2006) to conduct a retrospective cohort study of 36,079 patients with colon cancer to determine the independent effect of MetS and its components on overall survival (OS) and recurrence‐free rates (RFRs). Data on MetS and its components were ascertained from Medicare claims. OS and RFRs in patients with and without MetS and its components were compared using multivariate Cox models.
RESULTS:
MetS had no apparent effect on OS or RFR. Both elevated glucose/diabetes mellitus (DM) and elevated hypertension were associated with worse OS (adjusted hazard ratio [aHR], 1.17 [95% confidence interval, 1.13‐1.21] and 1.08 [95% confidence interval, 1.03‐1.12], respectively) and worse RFRs (aHR, 1.25 [95% confidence interval, 1.16‐1.34] and 1.22 [95% confidence interval, 1.12‐1.33], respectively). In contrast, dyslipidemia was associated with improved survival (aHR, 0.77; 95% confidence interval, 0.75‐0.80) and reduced recurrence (aHR, 0.71; 95% confidence interval, 0.66‐0.75). These effects were consistent for both men and women and were more pronounced in patients with early stage disease.
CONCLUSIONS:
MetS had no apparent effect on colon cancer outcomes, probably because of the combined adverse effects of elevated glucose/DM and hypertension and the protective effect of dyslipidemia in patients with nonmetastatic disease. The authors concluded that patients who have early stage colon cancer with elevated glucose/DM and/or hypertension may benefit from more intensive surveillance and/or broader use of adjuvant therapy and that trials to define the benefits of low‐fat diets, insulin‐lowering agents, and statins on recurrence/survival in patients with nonmetastatic colon cancer are warranted. Cancer 2013. © 2012 American Cancer Society.
Metabolic syndrome has no apparent effect on colon cancer outcomes. This effect probably is attributable to the combined adverse effects of elevated glucose/diabetes mellitus and hypertension and the protective effect of dyslipidemia in patients with nonmetastatic disease.</description><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>Cohort Studies</subject><subject>colon cancer</subject><subject>Colonic Neoplasms - epidemiology</subject><subject>Colonic Neoplasms - metabolism</subject><subject>Colonic Neoplasms - mortality</subject><subject>Colonic Neoplasms - pathology</subject><subject>diabetes mellitus</subject><subject>dyslipidemia</subject><subject>elevated glucose</subject><subject>Female</subject><subject>Humans</subject><subject>hypertension</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Metabolic diseases</subject><subject>metabolic syndrome</subject><subject>Metabolic Syndrome - epidemiology</subject><subject>Metabolic Syndrome - metabolism</subject><subject>Metabolic Syndrome - pathology</subject><subject>Miscellaneous</subject><subject>Neoplasm Recurrence, Local - epidemiology</subject><subject>Neoplasm Recurrence, Local - metabolism</subject><subject>Neoplasm Recurrence, Local - mortality</subject><subject>Neoplasm Recurrence, Local - pathology</subject><subject>Other metabolic disorders</subject><subject>recurrence</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>SEER Program</subject><subject>survival</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>United States - epidemiology</subject><issn>0008-543X</issn><issn>1097-0142</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp90F1LwzAUBuAgipvTG3-A5EYQoTNpmrW5lDI_QBREwbuS5gMiaTKTdrJ_b2an3nmVhPPkHM4LwClGc4xQfiWcCPO8ZDnZA1OMWJkhXOT7YIoQqjJakLcJOIrxPT3LnJJDMMlJXiFCyBSIpdZK9NBr2Kmet94aAePGyeA7BbmT0PQRCt-tvFMuXb2DQYkhBOXECOIQ1mbNLTQuQZuA4KkW4Ir3ZvvnGBxobqM62Z0z8HqzfKnvsoen2_v6-iEThFGSlRjRikisyha3BSLVgkrZUik05ZTxnEmKmF4UQknUMqkLSUSFCi5b1laFVmQGLsa-q-A_BhX7pjNRKGu5U36IDSZpe5ICYolejlQEH2NQulkF0_GwaTBqtqE221Cb71ATPtv1HdpOyV_6k2IC5zvAo-BWh7S_iX-uxKxI0SeHR_dprNr8M7KpH-vncfgXWM2QSA</recordid><startdate>20130415</startdate><enddate>20130415</enddate><creator>Yang, Yang</creator><creator>Mauldin, Patrick D.</creator><creator>Ebeling, Myla</creator><creator>Hulsey, Thomas C.</creator><creator>Liu, Baorui</creator><creator>Thomas, Melanie B.</creator><creator>Camp, Ernest R.</creator><creator>Esnaola, Nestor F.</creator><general>Wiley Subscription Services, Inc., A Wiley Company</general><general>Wiley-Blackwell</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130415</creationdate><title>Effect of metabolic syndrome and its components on recurrence and survival in colon cancer patients</title><author>Yang, Yang ; Mauldin, Patrick D. ; Ebeling, Myla ; Hulsey, Thomas C. ; Liu, Baorui ; Thomas, Melanie B. ; Camp, Ernest R. ; Esnaola, Nestor F.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3953-710583d1e7b1b403865ddb5dcf5a59a29d509f64ced0b9df4d3c804adb9b84fe3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Biological and medical sciences</topic><topic>Cohort Studies</topic><topic>colon cancer</topic><topic>Colonic Neoplasms - epidemiology</topic><topic>Colonic Neoplasms - metabolism</topic><topic>Colonic Neoplasms - mortality</topic><topic>Colonic Neoplasms - pathology</topic><topic>diabetes mellitus</topic><topic>dyslipidemia</topic><topic>elevated glucose</topic><topic>Female</topic><topic>Humans</topic><topic>hypertension</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Metabolic diseases</topic><topic>metabolic syndrome</topic><topic>Metabolic Syndrome - epidemiology</topic><topic>Metabolic Syndrome - metabolism</topic><topic>Metabolic Syndrome - pathology</topic><topic>Miscellaneous</topic><topic>Neoplasm Recurrence, Local - epidemiology</topic><topic>Neoplasm Recurrence, Local - metabolism</topic><topic>Neoplasm Recurrence, Local - mortality</topic><topic>Neoplasm Recurrence, Local - pathology</topic><topic>Other metabolic disorders</topic><topic>recurrence</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>SEER Program</topic><topic>survival</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>United States - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Yang</creatorcontrib><creatorcontrib>Mauldin, Patrick D.</creatorcontrib><creatorcontrib>Ebeling, Myla</creatorcontrib><creatorcontrib>Hulsey, Thomas C.</creatorcontrib><creatorcontrib>Liu, Baorui</creatorcontrib><creatorcontrib>Thomas, Melanie B.</creatorcontrib><creatorcontrib>Camp, Ernest R.</creatorcontrib><creatorcontrib>Esnaola, Nestor F.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Yang</au><au>Mauldin, Patrick D.</au><au>Ebeling, Myla</au><au>Hulsey, Thomas C.</au><au>Liu, Baorui</au><au>Thomas, Melanie B.</au><au>Camp, Ernest R.</au><au>Esnaola, Nestor F.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Effect of metabolic syndrome and its components on recurrence and survival in colon cancer patients</atitle><jtitle>Cancer</jtitle><addtitle>Cancer</addtitle><date>2013-04-15</date><risdate>2013</risdate><volume>119</volume><issue>8</issue><spage>1512</spage><epage>1520</epage><pages>1512-1520</pages><issn>0008-543X</issn><eissn>1097-0142</eissn><coden>CANCAR</coden><abstract>BACKGROUND:
Although epidemiologic studies suggest that metabolic syndrome (MetS) increases the risk of colorectal cancer, its effect on cancer mortality remains controversial.
METHODS:
The authors used the Surveillance, Epidemiology, and End Results (SEER)‐Medicare linked database (1998‐2006) to conduct a retrospective cohort study of 36,079 patients with colon cancer to determine the independent effect of MetS and its components on overall survival (OS) and recurrence‐free rates (RFRs). Data on MetS and its components were ascertained from Medicare claims. OS and RFRs in patients with and without MetS and its components were compared using multivariate Cox models.
RESULTS:
MetS had no apparent effect on OS or RFR. Both elevated glucose/diabetes mellitus (DM) and elevated hypertension were associated with worse OS (adjusted hazard ratio [aHR], 1.17 [95% confidence interval, 1.13‐1.21] and 1.08 [95% confidence interval, 1.03‐1.12], respectively) and worse RFRs (aHR, 1.25 [95% confidence interval, 1.16‐1.34] and 1.22 [95% confidence interval, 1.12‐1.33], respectively). In contrast, dyslipidemia was associated with improved survival (aHR, 0.77; 95% confidence interval, 0.75‐0.80) and reduced recurrence (aHR, 0.71; 95% confidence interval, 0.66‐0.75). These effects were consistent for both men and women and were more pronounced in patients with early stage disease.
CONCLUSIONS:
MetS had no apparent effect on colon cancer outcomes, probably because of the combined adverse effects of elevated glucose/DM and hypertension and the protective effect of dyslipidemia in patients with nonmetastatic disease. The authors concluded that patients who have early stage colon cancer with elevated glucose/DM and/or hypertension may benefit from more intensive surveillance and/or broader use of adjuvant therapy and that trials to define the benefits of low‐fat diets, insulin‐lowering agents, and statins on recurrence/survival in patients with nonmetastatic colon cancer are warranted. Cancer 2013. © 2012 American Cancer Society.
Metabolic syndrome has no apparent effect on colon cancer outcomes. This effect probably is attributable to the combined adverse effects of elevated glucose/diabetes mellitus and hypertension and the protective effect of dyslipidemia in patients with nonmetastatic disease.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>23280333</pmid><doi>10.1002/cncr.27923</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Aged, 80 and over Biological and medical sciences Cohort Studies colon cancer Colonic Neoplasms - epidemiology Colonic Neoplasms - metabolism Colonic Neoplasms - mortality Colonic Neoplasms - pathology diabetes mellitus dyslipidemia elevated glucose Female Humans hypertension Male Medical sciences Metabolic diseases metabolic syndrome Metabolic Syndrome - epidemiology Metabolic Syndrome - metabolism Metabolic Syndrome - pathology Miscellaneous Neoplasm Recurrence, Local - epidemiology Neoplasm Recurrence, Local - metabolism Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - pathology Other metabolic disorders recurrence Retrospective Studies Risk Factors SEER Program survival Survival Rate Treatment Outcome Tumors United States - epidemiology |
| title | Effect of metabolic syndrome and its components on recurrence and survival in colon cancer patients |
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