Metabolic syndrome and survival of patients with hepatocellular carcinoma: A meta-analysis

Abstract

BackgroundMetabolic syndrome (MetS) has been related to a high incidence of hepatocellular carcinoma (HCC). However, the influence of MetS on survival of patients with HCC is still unclear. We performed a systematic review and meta-analysis to evaluate the association between MetS and survival of HCC patients.MethodsA search of PubMed, Embase, and Web of Science retrieved relevant cohort studies from the inception of the databases to October 16, 2022. Data collection, literature search, and statistical analysis were carried out independently by two authors. We pooled the results using a random-effects model that incorporates heterogeneity.ResultsIn the meta-analysis, 8080 patients with HCC were included from ten cohort studies, and 1166 patients (14.4%) had MetS. Eight studies included patients treated primarily with radical hepatectomy, one study with patients receiving sorafenib, and another study included patients who were treated with radical hepatectomy or non-surgical treatments. Pooled results showed that MetS was associated with poor overall survival (OS, risk ratio [RR]: 1.21, 95% confidence interval [CI]:1.08 to 1.37, p = 0.001; I2 = 32%) and progression-free survival (PFS, RR: 1.33, 95% CI: 1.18 to 1.49, p < 0.001, I2 = 14%). Influencing analysis by excluding one study at a time showed consistent results (p all < 0.05). Subgroup analyses showed similar results in studies with MetS diagnosed with the National Cholesterol Education Program Adult Treatment Panel III or International Diabetes Federal criteria, and in studies with mean follow-up durations < or ≥ 3.5 years (p for subgroup difference all > 0.05).ConclusionIn patients with HCC, MetS may be a risk factor of poor OS and PFS, particularly for those after radical hepatectomy.

Molecular Mechanisms of Western Diet-Induced Obesity and Obesity-Related Carcinogenesis—A Narrative Review

“…In the 1970s, Denis Burkitt proposed that an ingestion threshold of 50 g per day of dietary fibre was necessary to inhibit cholesterol absorption, improve constipation and straining at stool, and prevent Western diet-related diseases including obesity, Obesity and metabolic syndrome not only increase the risk of primary cancers, but also influence prognosis after cancer treatment [221][222][223][224][225]. Lower cancer recurrence rates and improved survivorship are reported in bariatric surgical patients who were subsequently treated for cancer, compared to obese control patients [197,[226][227][228].…”

“…Sufficiently powered, randomized controlled trials are required to prove the benefits [216][217][218][219][220] (Figure 11). Obesity and metabolic syndrome not only increase the risk of primary cancers, but also influence prognosis after cancer treatment [221][222][223][224][225]. Lower cancer recurrence rates and improved survivorship are reported in bariatric surgical patients who were subsequently treated for cancer, compared to obese control patients [197,[226][227][228].…”