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- Title
Type 2 Diabetes Mellitus Is Associated With Increased Mortality in Chinese Patients Receiving Curative Surgery for Colon Cancer.
- 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
- 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.
- Subjects
TAIWAN; MORTALITY risk factors; TYPE 2 diabetes complications; MORTALITY; CHI-squared test; COLON tumors; CONFIDENCE intervals; RECTUM tumors; RESEARCH funding; T-test (Statistics); PROPORTIONAL hazards models; RETROSPECTIVE studies; DATA analysis software; DESCRIPTIVE statistics; KAPLAN-Meier estimator; LOG-rank test
- Publication
Oncologist, 2014, Vol 19, Issue 9, p951
- ISSN
1083-7159
- Publication type
Article
- DOI
10.1634/theoncologist.2013-0423