Patients with Old Age or Proximal Tumors Benefit from Metabolic Syndrome in Early Stage Gastric Cancer

Abstract

BackgroundMetabolic syndrome and/or its components have been demonstrated to be risk factors for several cancers. They are also found to influence survival in breast, colon and prostate cancer, but the prognostic value of metabolic syndrome in gastric cancer has not been investigated.MethodsClinical data and pre-treatment information of metabolic syndrome of 587 patients diagnosed with early stage gastric cancer were retrospectively collected. The associations of metabolic syndrome and/or its components with clinical characteristics and overall survival in early stage gastric cancer were analyzed.ResultsMetabolic syndrome was identified to be associated with a higher tumor cell differentiation (P = 0.036). Metabolic syndrome was also demonstrated to be a significant and independent predictor for better survival in patients aged >50 years old (P = 0.009 in multivariate analysis) or patients with proximal gastric cancer (P = 0.047 in multivariate analysis). No association was found between single metabolic syndrome component and overall survival in early stage gastric cancer. In addition, patients with hypertension might have a trend of better survival through a good control of blood pressure (P = 0.052 in univariate analysis).ConclusionsMetabolic syndrome was associated with a better tumor cell differentiation in patients with early stage gastric cancer. Moreover, metabolic syndrome was a significant and independent predictor for better survival in patients with old age or proximal tumors.

Preoperative Metabolic Syndrome Is Predictive of Significant Gastric Cancer Mortality after Gastrectomy: The Fujian Prospective Investigation of Cancer (FIESTA) Study

“…In contrast, another study among 505 Korean patients receiving radical gastrectomy for gastric cancer demonstrated that the coexistence of MetS before surgery increased the risk of gastric cancer mortality and control of MetS might improve the therapeutic efficacy (Kim et al, 2014). These conflicting and inconclusive results are likely due to the retrospective designs and a small cohort of patients in these studies (Wei et al, 2014, Kim et al, 2014). To better evaluate the potential contribution of preoperative MetS to the mortality of postoperative gastric cancer patients, we elicited a subset of data from the Fujian prospective investigation of cancer (FIESTA) study that incorporated 3012 patients with gastric cancer over a 15-year follow-up period.…”

“…Recent studies also demonstrate a carcinogenic function of MetS in many types of cancer, including gastric cancer (Cantiello et al, 2015, Zhu et al, 2010, Pasanisi et al, 2006, Wei et al, 2014, Kim et al, 2014). Several large cohort studies from Western countries, including the United States, have investigated the association of MetS and single metabolic risk elements with gastric cancer development and clinical outcomes (Lin et al, 2015, Lindkvist et al, 2013).…”

“…A retrospective study by Wei et al revealed that preoperative MetS status was a significant and independent predictor for better survival among 587 Chinese patients with early stage gastric cancer (Wei et al, 2014). In contrast, another study among 505 Korean patients receiving radical gastrectomy for gastric cancer demonstrated that the coexistence of MetS before surgery increased the risk of gastric cancer mortality and control of MetS might improve the therapeutic efficacy (Kim et al, 2014).…”

Impact of metabolic syndrome on the survival of Chinese patients with resectable esophageal squamous cell carcinoma

“…However, because the Asian body size is smaller than other ethnic groups, we used a BMI ≥ 25 kg/m 2 instead of BMI ≥ 30 kg/m 2 . Previous studies on Asian population also used this Asian‐specific cutoff value (BMI ≥ 25 kg/m 2 ) . Additional criteria included the following: (i) triglycerides ≥ 150 mg/dL (1.7 mmol/L); (ii) HDL ≤ 40 mg/dL (1.04 mmol/L) for men, ≤ 50 mg/dL (1.3 mmol/L) for women; and (iii) hypertension, systolic blood pressure ≥130/diastolic blood pressure ≥80 mmHg.…”

“…MetS is also a poor prognostic factor in colorectal cancer, . However, MetS is a significant predictor for better survival in certain patient subgroups with gastric tumors, including patients with old age or proximal tumors …”