Anderson Brandon J, Wahlquist Amy E, Hill Elizabeth G, Marshall David T, Kimchi Eric T, Staveley O'Carroll Kevin F, Camp E Ramsay
Department of Surgery, Medical University of South Carolina, Charleston, SC 29425, USA.
Department of Public Health Sciences, Charleston, SC 29425, USA; Hollings Cancer Center, Charleston, SC 29425, USA.
Int J Surg. 2016 Sep;33 Pt A(Pt A):8-12. doi: 10.1016/j.ijsu.2016.07.011. Epub 2016 Jul 16.
Metabolic syndrome (MetS) is a constellation of cardiovascular risk factors shown to increase the risk of developing various malignancies, as well as diminish tumor response to conventional therapies. The effects of MetS and its individual components on therapeutic response and treatment-related outcomes were examined in patients with locally advanced rectal cancer (LARC).
Data was retrospectively collected on LARC patients treated with neoadjuvant chemoradiation (nCRT) and surgery. Medical records were reviewed for patient characteristics, staging, treatment plan, and outcomes.
One hundred two patients were included in the study. Patients with HTN had a significantly decreased nCRT response and were four times more likely to experience a poor response to treatment compared to patients without HTN. Additionally, HTN was found to significantly increase the rate of surgical complications. Neither DM nor obesity exhibited any significant effect on therapeutic response or complication rates, either individually or in combination with another risk factor.
This study demonstrates the importance of considering underlying MetS risk factors, especially HTN, when predicting tumor response in LARC patients undergoing nCRT followed by radical surgery. The results provide support for an increased focus on pre-treatment risk factor control to optimize cancer therapy outcomes.
代谢综合征(MetS)是一组心血管危险因素,已显示会增加患各种恶性肿瘤的风险,并降低肿瘤对传统疗法的反应。本研究在局部晚期直肠癌(LARC)患者中,探讨了代谢综合征及其各个组成部分对治疗反应和治疗相关结局的影响。
回顾性收集接受新辅助放化疗(nCRT)及手术治疗的LARC患者的数据。查阅病历以获取患者特征、分期、治疗方案及结局。
本研究共纳入102例患者。与无高血压(HTN)的患者相比,HTN患者的nCRT反应显著降低,且治疗反应不佳的可能性高出四倍。此外,发现HTN会显著增加手术并发症的发生率。无论是单独存在还是与另一危险因素合并存在,糖尿病(DM)和肥胖均未对治疗反应或并发症发生率产生任何显著影响。
本研究表明,在预测接受nCRT后行根治性手术的LARC患者的肿瘤反应时,考虑潜在的MetS危险因素,尤其是HTN,具有重要意义。研究结果支持更加关注治疗前危险因素的控制,以优化癌症治疗结局。