Type 2 Diabetes Mellitus Is Associated With Increased Mortality in Chinese Patients Receiving Curative Surgery for Colon Cancer. (24th July 2014)

• Record Type: Journal Article
• Authors: Chen, Kuo-Hsing; Shao, Yu-Yun; Lin, Zhong-Zhe; Yeh, Yi-Chun; Shau, Wen-Yi; Kuo, Raymond Nienchen; Chen, Ho-Min; Lai, Chiu-Ling; Yeh, Kun-Huei; Cheng, Ann-Lii; Lai, Mei-Shu
• Is Part Of: Oncologist. Volume 19:Number 9(2014)
• Page Start: 951
• Page End: 958
• Publication Date: 2014-07-24
• Subjects: Cancer registry -- Diabetes mellitus -- Colorectal cancer -- Prognosis; Oncology -- Periodicals; Tumors -- Periodicals; Cancérologie -- Périodiques; Tumeurs -- Périodiques; Oncology; Tumors; Neoplasms; Electronic journals; Periodicals; Periodicals; 616.994
• DOI: 10.1634/theoncologist.2013-0423
• Languages: English
• ISSNs: 1083-7159

Abstract

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. Abstract : The current study retrospectively examined the association of diabetes mellitus (DM) and colon cancer prognosis in a population-based cohort in Taiwan. Data from the National Cancer Registry and the National Health Insurance system databases in Taiwan were reviewed to establish a patient cohort representative of the general population. Among patients who receive curative surgery for early colon cancer, DM was determined to be a predictor of increased overall mortality.