Metabolic Syndrome, Gastric Cancer Mortality and Competing Risk Survival Analysis

Mohamad Amin Pourhoseingholi,Sara Ashtari,Nastaran Hajizadeh,Mohammad Reza Zali

doi:10.1016/j.ebiom.2016.12.015

Mohamad Amin Pourhoseingholi, Sara Ashtari + Show 2 more

Open Access

https://doi.org/10.1016/j.ebiom.2016.12.015

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Abstract

Hu and colleagues in their recently published paper in EBioMedicine (Hu et al., 2017-in this issue) regarding the impact of metabolic syndrome (Mets) on gastric cancer mortality, conducted a prospective study (Fujian prospective investigation of cancer) on 3012 patients with gastric cancer, from 2000 to 2010, which latest follow-up have been done in 2015. During these 15 years, 1331 of 3012 patients died of gastric cancer. The median survival time (MST) of patients with MetS was 31.3 months, which was significantly shorter than that of MetS-free patients (157.1 months) and the coexistence of MetS before surgery was associated with a 2.3-fold increased risk for gastric cancer mortality. Also in a multivariate analysis, they reported the increasing hazard ratio of gastric cancer mortality, associated with invasion depth T1/T2, regional lymph node metastasis N0, positive distant metastasis, TNM stage I/II, intestinal type, negative tumor embolus and tumor size ≤ 4.5 cm. finally, survival tree analysis confirmed the top splitting role of TNM stage, followed by MetS or hyperglycemia with remarkable discrimination ability.

Highlights

Hu and colleagues in their recently published paper in EBioMedicine (Hu et al, 2017-in this issue) regarding the impact of metabolic syndrome (Mets) on gastric cancer mortality, conducted a prospective study (Fujian prospective investigation of cancer) on 3012 patients with gastric cancer, from 2000 to 2010, which latest follow-up have been done in 2015
The main finding of Hu and colleagues is an important issue, for clinicians who are facing with the gastric cancer patients, and for health policy makers in Asian countries who are challenging with the burden of cancers in their own populations
The burden of gastrointestinal cancer is increasing in Asia because of aging, growth of the population and the risk factors including smoking, obesity, and changing lifestyle (Pourhoseingholi et al, 2015), which would increases the risk of MetS too

Summary

Introduction

Hu and colleagues in their recently published paper in EBioMedicine (Hu et al, 2017-in this issue) regarding the impact of metabolic syndrome (Mets) on gastric cancer mortality, conducted a prospective study (Fujian prospective investigation of cancer) on 3012 patients with gastric cancer, from 2000 to 2010, which latest follow-up have been done in 2015. The follow-up process, data gathering methods, MetS assessment and Demographic and Clinicopathologic Characteristics which included in the analysis, were the other positive points of this study. For statistical analysis, multivariate Weibull proportional hazards regression model before and after adjusting for confounding factors, were used.

Results

Conclusion