prognosis in cervical cancer is lacking. This study investigated the association between MetS and recurrence-free survival. (RFS) in patients with early-stage ...
Tumor Biol. DOI 10.1007/s13277-014-2831-y
RESEARCH ARTICLE
Metabolic components and recurrence in early-stage cervical cancer Hee Kyung Ahn & Jin Woo Shin & Hong Yup Ahn & Chan-Yong Park & Nak Woo Lee & Jae Kwan Lee & In Cheol Hwang
Received: 4 August 2014 / Accepted: 7 November 2014 # International Society of Oncology and BioMarkers (ISOBM) 2014
Abstract Epidemiological evidence suggests that the metabolic syndrome (MetS) is associated with increased risk of cervical cancer. However, research on the impact of MetS on prognosis in cervical cancer is lacking. This study investigated the association between MetS and recurrence-free survival (RFS) in patients with early-stage cervical cancer. This is a retrospective study of patients diagnosed with the International Federation of Gynecology and Obstetrics (FIGO) stage I-II cervical cancer in three tertiary hospitals during 2006–2009. Cox proportional hazards model was used to estimate the association between MetS or MetS components and RFS. We were able to evaluate MetS status in 84 patients out of 127. Forty patients had MetS. RFS was not significantly different according to MetS status; however, there was no further event of recurrence in non-MetS group after 2 years from primary surgical treatment. Hypertriglyceridemia (HR
3.67, 95 % CI 1.18–11.43) and impaired fasting glucose (HR 4.30, 95 % CI 1.23–15.03) were independent risk factors for shorter RFS, after adjustment for age, lymph node involvement, tumor involvement of resection margin, parametrial invasion, FIGO stage at diagnosis, and adjuvant treatment. Hypertriglyceridemia and impaired fasting glucose were associated with higher risk of recurrence in patients with earlystage cervical cancer. Prospective validation in large populations and further studies on the impact of MetS treatment in patients with cervical cancer are warranted.
Hee Kyung Ahn and Jin Woo Shin contributed equally to this article.
Cervical cancer remains a major health problem worldwide and is the second most common cause of cancer mortality among women [1]. With advances in cervical cancer screening, early-stage diagnosis is increasing; however, tumors still recur in up to 30 % of radically treated patients with the International Federation of Gynecology and Obstetrics (FIGO) stage I-II cervical cancer [2, 3]. Recurrence is the main reason for decreased survival and poor quality of life in patients with early-stage cervical cancer who finished primary treatment. Although clinical stage at diagnosis remains the most important determinant of prognosis, a growing body of evidence suggests several other potential prognostic factors, including the metabolic syndrome (MetS). MetS is defined as a cluster of disorders including high blood pressure (BP), insulin resistance, excess body weight with central obesity, and dyslipidemia [4]. In addition to the central feature of MetS of increased risk of cardiovascular disease and diabetes [5, 6], MetS carries a risk of developing cancers. Epidemiological studies have
H. K. Ahn Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea J. W. Shin : C.
