Metabolic syndrome is associated with improved cancer-specific survival in patients with localized clear cell renal cell carcinoma

Zhenhua Liu, Haifeng Wang, Lian Zhang, Shaobo Li, Yu Fan, Yisen Meng, Shuai Hu, Qian Zhang, Zhisong He, Liqun Zhou, Wenke Han, Wei Yu, Jie Jin


Background: Metabolic syndrome (MetS) has been found to be prevalent in cancer and have implications in cancer outcomes. In this study, we attempted to evaluate the prognostic value of MetS in localized clear cell renal cell carcinoma (ccRCC) patients.
Methods: We retrospectively collected clinicopathological data and pre-treatment laboratory test results of 480 patients with localized (T1–2N0M0) ccRCC undergoing radical or partial nephrectomy in Peking University First Hospital. MetS was diagnosed by criteria of the 2004 Chinese Medical Association Diabetes Society. Univariate and multivariate analyses were conducted to analyze the association between clinicopathological characteristics, MetS, and disease outcomes.
Results: In our cohort, 136 patients (28.3%) were diagnosed with MetS. Among them, 113 (83.1%) were men, suggesting that men were more likely to have MetS. This syndrome was also associated with increased pre-treatment creatinine levels. Median follow-up time was 70 months (range, 1–118 months) and 5-year overall survival (OS) rate was 92%. MetS was an independent favorable factor of cancer-specific survival (CSS) (P=0.017), and similar results were observed in Fuhrman nuclear grade 1–2 ccRCC patients by further analysis. Neither of the four components of the MetS (hypertension, diabetes mellitus, overweight/obesity and dyslipidemia) was an independent predictor of CSS. Patients who met more than 3 of the 4 criteria for MetS had higher CSS than those who met fewer than 2 criteria.
Conclusions: MetS is an independent prognostic factor for better CSS in localized ccRCC patients.