Type 2 Diabetes Mellitus is Associated with Increased Mortality in Chinese Patients Receiving Curative Surgery for Colon Cancer

Overview

Journal Oncologist

Publisher Oxford University Press

Specialty Oncology

Date 2014 Jul 26

PMID 25061090

Citations 17

Authors

Kuo-Hsing Chen

Yu-Yun Shao

Zhong-Zhe Lin

Yi-Chun Yeh

Wen-Yi Shau

Raymond Nienchen Kuo

Ho-Min Chen

Chiu-Ling Lai

Kun-Huei Yeh

Ann-Lii Cheng

Mei-Shu Lai

Affiliations

Soon will be listed here.

Abstract

Background: We investigated the association between diabetes mellitus (DM) and the prognosis of patients with early colon cancer who had undergone curative surgery.

Methods: From three national databases of patients in Taiwan, we selected a cohort of colon cancer patients who had been newly diagnosed with stage I or stage II colon cancer between January 1, 2004 and December 31, 2008 and had undergone curative surgery. We collected information regarding DM (type 2 DM only), the use of antidiabetic medications, other comorbidities, and survival outcomes. The colon cancer-specific survival (CSS) and the overall survival (OS) were compared between patients with and without DM.

Results: We selected 6,937 colon cancer patients, among whom 1,371 (19.8%) had DM. The colon cancer patients with DM were older and less likely to receive adjuvant chemotherapy but had a similar tumor stage and grade, compared with colon cancer patients without DM. Compared with colon cancer patients without DM, patients with DM had significantly shorter OS (5-year OS: 71.0% vs. 81.7%) and CSS (5-year CSS: 86.7% vs. 89.2%). After adjusting for age, sex, stage, adjuvant chemotherapy, and comorbidities in our multivariate analysis, DM remained an independent prognostic factor for overall mortality (adjusted hazards ratio: 1.32, 95% confidence interval: 1.18-1.49), but not for cancer-specific mortality. Among the colon cancer patients who had received antidiabetic drug therapy, patients who had used insulin had significantly shorter CSS and OS than patients who had not.

Conclusion: Among patients who receive curative surgery for early colon cancer, DM is a predictor of increased overall mortality.

Citing Articles

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Marked paper: Type 2 diabetes mellitus indicates increased postoperative complications and poor prognosis in colorectal cancer patients receiving curative surgery.

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