Abstract
Background and Objectives: Growing evidence indicates that metabolic syndrome confers a differential risk for the development and progression of many types of cancer, especially in the digestive tract system. We here synthesized the results of published cohort studies to test whether baseline metabolic syndrome and its components can predict survival in patients with esophageal, gastric, or colorectal cancer.Methods: Literature retrieval, publication selection and data extraction were performed independently by two authors. Analyses were done using STATA software (version 14.1).Results: A total of 15 publications involving 54,656 patients were meta-analyzed. In overall analyses, the presence of metabolic syndrome was associated with a non-significant 19% increased mortality risk for digestive tract cancer (hazard ratio [HR]: 1.19; 95% confidence interval [CI]: 1.45 to 2.520.95 to 1.49, P = 0.130; I2: 94.8%). In stratified analyses, the association between metabolic syndrome and digestive tract cancer survival was statistically significant in prospective studies (HR: 1.64, 95% CI: 1.18 to 2.28), in studies involving postsurgical patients (HR: 1.42, 95% CI: 1.06 to 1.92), and in studies assessing cancer-specific survival (HR: 1.91, 95% CI: 1.45 to 2.52). Further meta-regression analyses indicated that age and smoking were potential sources of between-study heterogeneity (both P < 0.001). The shape of the Begg's funnel plot seemed symmetrical (Begg's test P = 0.945 and Egger's test P = 0.305).Conclusions: Our findings indicate that metabolic syndrome is associated with an increased risk of postsurgical digestive tract cancer-specific mortality. Continued investigations are needed to uncover the precise molecule mechanism linking metabolic syndrome and digestive tract cancer.
Highlights
The burden of metabolic syndrome is increasing globally, and the clusters of metabolic risk factors differ regionally [1]
The association between metabolic syndrome and digestive tract cancer was statistically significant in prospective studies (HR: 1.64, 95% confidence interval (95% CI): 1.18 to 2.28)
ES, effect size; 95% CI, 95% confidence interval; I2, inconsistency index; CRC, colorectal cancer; ESCC, esophageal squamous cell carcinoma; GC, gastric cancer; TNM, tumor node metastasis
Summary
The burden of metabolic syndrome is increasing globally, and the clusters of metabolic risk factors differ regionally [1]. Emerging evidence from epidemiologic, clinical and experimental studies indicates that metabolic syndrome confers a differential risk for the development and progression of many types of cancer, especially in the digestive tract system [2,3,4]. Based on the above lines of evidence, we here developed a hypothesis that metabolic syndrome may be an important prognostic factor for common digestive tract cancer. Growing evidence indicates that metabolic syndrome confers a differential risk for the development and progression of many types of cancer, especially in the digestive tract system. We here synthesized the results of published cohort studies to test whether baseline metabolic syndrome and its components can predict survival in patients with esophageal, gastric, or colorectal cancer
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