Open AccessType 2 Diabetes Mellitus Is Associated With Increased Mortality in Chinese Patients Receiving Curative Surgery for Colon Cancer
Author(s) -
Chen KuoHsing,
Shao YuYun,
Lin ZhongZhe,
Yeh YiChun,
Shau WenYi,
Kuo Raymond Nienchen,
Chen HoMin,
Lai ChiuLing,
Yeh KunHuei,
Cheng AnnLii,
Lai MeiShu
Publication year - 2014
Publication title -
the oncologist
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.176
H-Index - 164
eISSN - 1549-490X
pISSN - 1083-7159
DOI - 10.1634/theoncologist.2013-0423
Subject(s) - medicine , colorectal cancer , cancer , cohort , diabetes mellitus , stage (stratigraphy) , gastroenterology , confidence interval , chemotherapy , proportional hazards model , surgery , oncology , paleontology , biology , endocrinology
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.