Cancer Res Treat.  2021 Jul;53(3):714-723. 10.4143/crt.2020.481.

Risk of Death in Colorectal Cancer Patients with Multi-morbidities of Metabolic Syndrome: A Retrospective Multicohort Analysis

• Feng Q
• Xu L
• Li L
• Qiu J
• Huang Z
• Jiang Y
• Wen T
• Lu S
• Meng F
• Shu X

• KMID: 2518395
• DOI: http://doi.org/10.4143/crt.2020.481

Abstract

Purpose
The prevalence of multi-morbidities with colorectal cancer (CRC) is known to be increasing. Particularly prognosis of CRC patients co-diagnosed with metabolic syndrome (MetSyn) was largely unknown. We aimed to examine the death risk of CRC patients according to the multiple MetSyn morbidities.
Materials and Methods
We identified CRC patients with MetSyn from the electronic medical records (EMR) systems in five independent hospitals during 2006-2011. Information on deaths was jointly retrieved from EMR, cause of death registry and chronic disease surveillance as well as study-specific questionnaire. Cox proportional hazards regression was used to calculate the overall and CRC-specific hazards ratios (HR) comparing MetSyn CRC cohort with reference CRC cohort.
Results
A total of 682 CRC patients in MetSyn CRC cohort were identified from 24 months before CRC diagnosis to 1 month after. During a median follow-up of 92 months, we totally observed 584 deaths from CRC, 245 being in MetSyn cohort and 339 in reference cohort. Overall, MetSyn CRC cohort had an elevated risk of CRC-specific mortality (HR, 1.49; 95% confidence interval [CI], 1.07 to 1.90) and overall mortality (HR, 1.43; 95% CI, 1.09 to 1.84) compared to reference cohort after multiple adjustment. Stratified analyses showed higher mortality risk among women (HR, 1.87; 95% CI, 1.04 to 2.27) and specific components of MetSyn. Notably, the number of MetSyn components was observed to be significantly related to CRC prognosis.
Conclusion
Our findings supported that multi-morbidities of MetSyn associated with elevated death risk after CRC. MetSyn should be considered as an integrated medical condition more than its components in CRC prognostic management.

Keyword

Colorectal neoplasms; Metabolic syndrome; Multi-morbidities; Risk of death; Prognosis

Figure

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  Fig. 1 Flow diagram of study participants. CRC, colorectal cancer; MetSyn, metabolic syndrome; PSM, propensity score matching.

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  Fig. 2 (A) Probability of cause-specific survival of colorectal cancer (CRC) patients co-diagnosed with metabolic syndrome (MetSyn) in comparison with CRC patients without MetSyn diagnosis. (B) Probability of overall survival of CRC patients co-diagnosed with MetSyn in comparison with CRC patients without MetSyn diagnosis.

Reference

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