Obesity and diabetes as prognostic factors in patients with colorectal cancer

Colorectal carcinoma is one of the most prevalent cancer types for both men and women. Prognosis of the disease is mostly defined by the stage. Localized disease has a better prognosis especially in earlier stages I and II. In addition most patients with more advanced localized stage III disease are expected to survive with a combination of surgery and adjuvant treatments. Progress in treatment of metastatic disease has led to median survivals exceeding 2 years and a minority of oligometastatic patients may survive even longer or be cured with multimodality therapy. Besides stage of the disease few prognostic factors are available to guide informative discussions with patients or guide therapeutic decisions. One area of research that may provide information in this direction is comorbidity conditions of the metabolic syndrome spectrum. Despite a significant body of literature investigating elements of the metabolic syndrome such as obesity and diabetes in isolation as risk and prognostic factors in colorectal cancer, a more restricted amount of research is dealing with the combination of these two factors as prognosticators of colorectal cancer. This paper will discuss published data on these factors and specifically their combination in the prognosis of colorectal cancer and will address some of their pathogenesis and therapy implications.