Skip to main content

Effect of metabolic syndrome and its components on recurrence and survival in early-stage non-small cell lung cancer

Medical Oncology volume 32, Article number: 423 (2015) Cite this article

Abstract

Previous studies have indicated that clustering of components of metabolic syndrome (MetS) increases the risk for the development of several cancers such as colon, prostate, and breast cancer. However, the prognostic role of MetS in early-stage non-small cell lung cancer (NSCLC) has not been well defined. We reviewed the clinical data and pre-treatment information of MetS of 545 patients with NSCLC who underwent radical surgery and were pathologically diagnosed as stage IB of NSCLC. The influence of MetS and/or its components on survival outcome was examined using Kaplan–Meier and Cox proportional hazards analyses. The patients with MetS showed no difference in survival outcome regarding overall survival (OS) and disease-free survival (DFS) compared with patients without MetS in univariate, multivariate, and stratification analyses. However, in univariate analysis, a high high density lipoprotein level was a good prediction factor for DFS (median DFS with vs. without MetS: 124.3 vs. 115.1 months P = 0.036). Other single MetS components showed no association with OS and DFS in early-stage NSCLC. For other clinical characteristic, the age and adjuvant therapy were the independent prognostic factors of OS in univariate and multivariate analyses. MetS and/or its components do not have significant prognostic value in early-stage NSCLC.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

Abbreviations

MetS:

Metabolic syndrome

NSCLC:

Non-small cell lung cancer

OS:

Overall survival

DFS:

Disease-free survival

HDL:

High density lipoprotein

TNM:

Tumor-node-metastasis

AJCC:

American joint committee on cancer

ATP III:

Adult treatment panel III

BMI:

Body mass index

CIs:

Confidence intervals

References

  1. Cowey S, Hardy RW. The metabolic syndrome: a high-risk state for cancer? Am J Pathol. 2006;169(5):1505–22.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  2. Third report of the national cholesterol education program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (adult treatment panel iii) final report. Circulation. 2002;106(25):3143–421.

  3. Jinjuvadia R, Patel S, Liangpunsakul S. The association between metabolic syndrome and hepatocellular carcinoma: systemic review and meta-analysis. J Clin Gastroenterol. 2014;48(2):172–7.

    CAS  PubMed  Article  Google Scholar 

  4. Ulaganathan V, Kandiah M, Zalilah MS, et al. Colorectal cancer and its association with the metabolic syndrome: a malaysian multi-centric case–control study. Asian Pac J Cancer Prev. 2012;13(8):3873–7.

    CAS  PubMed  Article  Google Scholar 

  5. Jinjuvadia R, Lohia P, Jinjuvadia C, et al. The association between metabolic syndrome and colorectal neoplasm: systemic review and meta-analysis. J Clin Gastroenterol. 2013;47(1):33–44.

    PubMed Central  PubMed  Article  Google Scholar 

  6. Borena W, Edlinger M, Bjørge T, et al. Correction: a prospective study on metabolic risk factors and gallbladder cancer in the metabolic syndrome and cancer (Me-Can) collaborative study. PLoS One. 2014;9(7):e102291.

  7. Borena W, Edlinger M, Bjorge T, et al. A prospective study on metabolic risk factors and gallbladder cancer in the metabolic syndrome and cancer (Me-Can) collaborative study. PLoS One. 2014;9(2):e89368.

    PubMed Central  PubMed  Article  Google Scholar 

  8. Friedenreich CM, Biel RK, Lau DC, et al. Case–control study of the metabolic syndrome and metabolic risk factors for endometrial cancer. Cancer Epidemiol Biomarkers Prev. 2011;20(11):2384–95.

    CAS  PubMed  Article  Google Scholar 

  9. Rosato V, Zucchetto A, Bosetti C, et al. Metabolic syndrome and endometrial cancer risk. Ann Oncol. 2011;22(4):884–9.

    CAS  PubMed  Article  Google Scholar 

  10. Zhang Y, Liu Z, Yu X, et al. The association between metabolic abnormality and endometrial cancer: a large case–control study in China. Gynecol Oncol. 2010;117(1):41–6.

    CAS  PubMed  Article  Google Scholar 

  11. Rosato V, Tavani A, Bosetti C, et al. Metabolic syndrome and pancreatic cancer risk: a case–control study in Italy and meta-analysis. Metabolism. 2011;60(10):1372–8.

    CAS  PubMed  Article  Google Scholar 

  12. Wu Q, Chen G, Wu WM, et al. Metabolic syndrome components and risk factors for pancreatic adenocarcinoma: a case–control study in China. Digestion. 2012;86(4):294–301.

    CAS  PubMed  Article  Google Scholar 

  13. Reeves KW, McLaughlin V, Fredman L, et al. Components of metabolic syndrome and risk of breast cancer by prognostic features in the study of osteoporotic fractures cohort. Cancer Causes Control. 2012;23(8):1241–51.

    PubMed Central  PubMed  Article  Google Scholar 

  14. Thomas GA, Alvarez-Reeves M, Lu L, et al. Effect of exercise on metabolic syndrome variables in breast cancer survivors. Int J Endocrinol. 2013;2013:168797.

    PubMed Central  PubMed  Article  Google Scholar 

  15. O’Doherty MG, Freedman ND, Hollenbeck AR, et al. A prospective cohort study of obesity and risk of oesophageal and gastric adenocarcinoma in the NIH–AARP diet and health study. Gut. 2012;61(9):1261–8.

    PubMed Central  PubMed  Article  Google Scholar 

  16. MacInnis RJ, English DR, Hopper JL, et al. Body size and composition and the risk of gastric and oesophageal adenocarcinoma. Int J Cancer. 2006;118(10):2628–31.

    CAS  PubMed  Article  Google Scholar 

  17. Kabat GC, Kim M, Hunt JR, et al. Body mass index and waist circumference in relation to lung cancer risk in the women’s health initiative. Am J Epidemiol. 2008;168(2):158–69.

    PubMed Central  PubMed  Article  Google Scholar 

  18. Lindgren A, Pukkala E, Nissinen A, et al. Blood pressure, smoking, and the incidence of lung cancer in hypertensive men in North Karelia, Finland. Am J Epidemiol. 2003;158(5):442–7.

    PubMed  Article  Google Scholar 

  19. Esposito K, Chiodini P, Colao A, et al. Metabolic syndrome and risk of cancer: a systematic review and meta-analysis. Diabetes Care. 2012;35(11):2402–11.

    PubMed Central  PubMed  Article  Google Scholar 

  20. Lee JS, Cho SI, Park HS. Metabolic syndrome and cancer-related mortality among korean men and women. Ann Oncol. 2010;21(3):640–5.

    CAS  PubMed  Article  Google Scholar 

  21. Jaggers JR, Sui X, Hooker SP, et al. Metabolic syndrome and risk of cancer mortality in men. Eur J Cancer. 2009;45(10):1831–8.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  22. Wei XL, Qiu MZ, Lin HX, et al. Patients with old age or proximal tumors benefit from metabolic syndrome in early stage gastric cancer. PLoS One. 2014;9(3):e89965.

    PubMed Central  PubMed  Article  Google Scholar 

  23. Matthews CE, Sui X, LaMonte MJ, et al. Metabolic syndrome and risk of death from cancers of the digestive system. Metabolism. 2010;59(8):1231–9.

    CAS  PubMed Central  PubMed  Article  Google Scholar 

  24. Yang Y, Mauldin PD, Ebeling M, et al. Effect of metabolic syndrome and its components on recurrence and survival in colon cancer patients. Cancer. 2013;119(8):1512–20.

    PubMed  Article  Google Scholar 

  25. Shen Z, Ye Y, Bin L, et al. Metabolic syndrome is an important factor for the evolution of prognosis of colorectal cancer: survival, recurrence, and liver metastasis. Am J Surg. 2010;200(1):59–63.

    PubMed  Article  Google Scholar 

  26. Kim EH, Lee H, Chung H, et al. Impact of metabolic syndrome on oncologic outcome after radical gastrectomy for gastric cancer. Clin Res Hepatol Gastroenterol. 2014;38(3):372–8.

    PubMed  Article  Google Scholar 

  27. Pasanisi P, Berrino F, De Petris M, et al. Metabolic syndrome as a prognostic factor for breast cancer recurrences. Int J Cancer. 2006;119(1):236–8.

    CAS  PubMed  Article  Google Scholar 

  28. Oh SW, Park CY, Lee ES, et al. Adipokines, insulin resistance, metabolic syndrome, and breast cancer recurrence: a cohort study. Breast Cancer Res. 2011;13(2):R34.

    PubMed Central  PubMed  Article  Google Scholar 

  29. Xiang YZ, Xiong H, Cui ZL, et al. The association between metabolic syndrome and the risk of prostate cancer, high-grade prostate cancer, advanced prostate cancer, prostate cancer-specific mortality and biochemical recurrence. J Exp Clin Cancer Res. 2013;32:9.

    PubMed Central  PubMed  Article  Google Scholar 

  30. Dahlberg SE, Schiller JH, Bonomi PB, et al. Body mass index and its association with clinical outcomes for advanced non-small-cell lung cancer patients enrolled on eastern cooperative oncology group clinical trials. J Thorac Oncol. 2013;8(9):1121–7.

    PubMed Central  PubMed  Article  Google Scholar 

  31. Attaran S, McShane J, Whittle I, et al. A propensity-matched comparison of survival after lung resection in patients with a high versus low body mass index. Eur J Cardiothorac Surg. 2012;42(4):653–8.

    PubMed  Article  Google Scholar 

  32. Varlotto J, Medford-Davis LN, Recht A, et al. Confirmation of the role of diabetes in the local recurrence of surgically resected non-small cell lung cancer. Lung Cancer. 2012;75(3):381–90.

    CAS  PubMed  Article  Google Scholar 

  33. Vargas T, Moreno-Rubio J, Herranz J, et al. Genes associated with metabolic syndrome predict disease-free survival in stage ii colorectal cancer patients. A novel link between metabolic dysregulation and colorectal cancer. Mol Oncol. 2014;8(8):1469–81.

  34. Colonna SV, Douglas Case L, Lawrence JA. A retrospective review of the metabolic syndrome in women diagnosed with breast cancer and correlation with estrogen receptor. Breast Cancer Res Treat. 2012;131(1):325–31.

    CAS  PubMed  Article  Google Scholar 

  35. Healy LA, Howard JM, Ryan AM, et al. Metabolic syndrome and leptin are associated with adverse pathological features in male colorectal cancer patients. Colorectal Dis. 2012;14(2):157–65.

    CAS  PubMed  Article  Google Scholar 

  36. Healy LA, Ryan AM, Carroll P, et al. Metabolic syndrome, central obesity and insulin resistance are associated with adverse pathological features in postmenopausal breast cancer. Clin Oncol (R Coll Radiol). 2010;22(4):281–8.

    CAS  Article  Google Scholar 

Download references

Acknowledgments

This research was supported by Grants from the Ministry of Science and Technology of China (No. 2012AA021503).

Conflict of interest

We declare that we have no conflict of interest.

Author information

Affiliations

  1. Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, No. 561 Dongfeng Road East, Guangzhou, 510060, Guangdong, People’s Republic of China

    Ying-Sheng Wen, Rong-qing Qin & Lan-Jun Zhang

  2. State Key Laboratory of Oncology in South China, Department of Thoracic Surgery, Sun Yat-sen University Cancer Center, No. 561 Dongfeng Road East, Guangzhou, 510060, Guangdong, People’s Republic of China

    Ying-Sheng Wen, Rong-qing Qin & Lan-Jun Zhang

  3. School of Medicine, University of Glasgow, Glasgow, UK

    Xue-wen Zhang

Authors
  1. Ying-Sheng Wen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Xue-wen Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Rong-qing Qin
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Lan-Jun Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Lan-Jun Zhang.

Additional information

Ying-Sheng Wen and Xue-wen Zhang contributed equally as first authors to this work.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Wen, YS., Zhang, Xw., Qin, Rq. et al. Effect of metabolic syndrome and its components on recurrence and survival in early-stage non-small cell lung cancer. Med Oncol 32, 423 (2015). https://doi.org/10.1007/s12032-014-0423-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s12032-014-0423-8

Keywords

  • Metabolic syndrome
  • Non-small cell lung cancer
  • Prognosis