Specific features of colorectal cancer in patients with metabolic syndrome: a matched case-control analysis of 772 patients

Langenbecks Arch Surg. 2018 Jun;403(4):443-450. doi: 10.1007/s00423-018-1677-y. Epub 2018 Apr 27.

Abstract

Purpose: Although association between colorectal cancer (CRC) and metabolic syndrome (MetS) is established, specific features of CRC arising in patients presenting with MetS have not been clearly identified.

Method: All patients who underwent colectomy for CRC from January 2005 to December 2014 at Institut Mutualiste Montsouris were identified from a prospectively collected database and characteristics were compared in the entire population and in a 1:2 matched case-control analysis [variables on which matching was performed were CRC localization (right- or left-sided) and AJCC stage (0 to IV)].

Results: Out of the 772 identified patients, 98 (12.7%) presented with MetS. Entire population analysis revealed that CRC associated with MetS was more frequent in men (71.4 vs. 47.8%, p < 0.001), more often right-sided (71.4 vs. 50.4%, p < 0.001) and presented with less synchronous liver metastasis (4.1 vs. 8.7%, p = 0.002). Case-control analysis confirmed the gender association (p < 0.001) and showed HNPCC (p < 0.001) and history family of CRC (p = 0.010) to be significantly more frequent in Non-MetS patients.

Conclusions: CRC associated with MetS is more frequent in men, more often right-sided, and presents with fewer synchronous metastasis. Further investigations should be designed in order to confirm these results and to enhance our knowledge of carcinogenesis related to MetS.

Keywords: Carcinogenesis; Colectomy; Colorectal cancer; Metabolic syndrome.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Colectomy
  • Colorectal Neoplasms / complications*
  • Colorectal Neoplasms / pathology*
  • Colorectal Neoplasms / surgery
  • Female
  • Humans
  • Liver Neoplasms / secondary*
  • Male
  • Metabolic Syndrome / complications*
  • Metabolic Syndrome / mortality
  • Metabolic Syndrome / pathology
  • Middle Aged
  • Neoplasm Staging
  • Sex Factors
  • Survival Analysis