The impact on clinical outcome of high prevalence of diabetes mellitus in Taiwanese patients with colorectal cancer
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WORLD JOURNAL OF SURGICAL ONCOLOGY
RESEARCH
Open Access
The impact on clinical outcome of high prevalence of diabetes mellitus in Taiwanese patients with colorectal cancer Ching-Wen Huang1,2,3†, Li-Chu Sun4,5†, Ying-Ling Shih4,5, Hsiang-Lin Tsai6,7, Chao-Wen Chen8, Yung-Sung Yeh8, Cheng-Jen Ma2, Che-Jen Huang2,9 and Jaw-Yuan Wang2,3,4,9,10,11,12*
Abstract Background: Both colorectal cancer (CRC) and diabetes mellitus (DM) are important public health problems worldwide. As there are controversies about survival impact on CRC patients with preexisting DM, the purpose of the present study is to evaluate the incidence and the survival impact of preexisting DM on the long-term outcomes of patients with CRC in Taiwan. Methods: From January 2002 to December 2008, 1,197 consecutive patients with histologically proven primary CRC, who received surgical treatment at a single institution, were enrolled. The clinicopathologic features between these patients with and without DM were retrospectively investigated. Moreover, we intended to analyze the impact of DM on overall survival (OS) and cancer-specific survival (CSS) rates. Results: Of 1,197 CRC patients, 23.6% of patients had either a reported history of DM or were currently taking one or more diabetes-controlling medications. CRC patients with DM were significantly older than those without DM (P < 0.001), and had a higher incidence of cardiac disease and higher body mass index than those without DM (both P < 0.001). There were no significant differences in gender, tumor size, tumor location, histological type, AJCC/UICC cancer stage, vascular invasion, perineural invasion, comorbidity of pulmonary disease or renal disease, and OS, and CSS between two groups. Additionally, DM patients had a higher incidence of second malignancy than patients without DM (9.54% vs 6.01%, P = 0.040). Conclusions: A considerably high prevalence of DM in CRC patients but no significant impact of DM on survival was observed in the single-institution retrospective study, regardless of cancer stages and tumor locations. Therefore, treatment strategies for CRC patients with DM should be the same as patients without DM. Keywords: High prevalence, Diabetes mellitus, Colorectal cancer, Survival impact
Background Colorectal cancer (CRC) is reported as the third most common cancer and the second leading cause of cancer death in the United States [1,2]. In the United States, an estimated 142,570 newly diagnosed cases of CRC and an estimated 51,370 cancer deaths from CRC were reported in 2010 [1]. * Correspondence: [email protected] † Equal contributors 2 Division of Gastroenterological and General Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan 3 Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Full list of author information is available at the end of the article
It has been reported that the incidence of CRC in economically transitioning countries continues to rise and t
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