Metabolic components and recurrence in early-stage cervical cancer

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 early-stage cervical cancer. Prospective validation in large populations and further studies on the impact of MetS treatment in patients with cervical cancer are warranted.