<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2019-0022_s_006_w2aab3b7b9b1b6b1aab1c18b1Aa"><h3>Background</h3><p>Diabetes mellitus (DM) and DM related comorbidities may initiate difficulties during cancer specific treatment and may have an impact on cancer management and outcome. The aim of our study was to find out if DM in patients with advanced colorectal carcinoma (CRC) is associated with cancer-specific or overall survival.</p></sec><sec id="j_raon-2019-0022_s_007_w2aab3b7b9b1b6b1aab1c18b2Aa"><h3>Patients and methods</h3><p>This study included 200 consecutive patients (131 males, 69 females, mean age 63 years) with elective CRC surgery at the Institute of Oncology Ljubljana and DM was found in 39 (19.5%) of them. Even 64% of patients had Stage 3 or 4 disease, so neo-adjuvant chemotherapy (CTX) and/or radiotherapy (RT) were carried out in 59% of cases. Data about gender, age, body mass index, presence of DM, American Society of Anesthesiologists (ASA) physical status score, stage of disease and postoperative complications were collected prospectively. Cancer-specific survival and overall survival were compared by log-rank test.</p></sec><sec id="j_raon-2019-0022_s_008_w2aab3b7b9b1b6b1aab1c18b3Aa"><h3>Results</h3><p>Patients with DM had a higher ASA score, BMI, the illness marker, rate of massive bleeding, blood transfusion and longer hospital stay than those without DM. The mean follow-up period was 4.75 years. All causes mortality in patients with DM and without DM was 23% and 27%, respectively. Three-year cancer-specific survival in patients with DM and without DM was 85% and 89%, respectively (p = 0.68). Three-year overall survival in patients with DM and without DM was 82% and 84%, respectively (p = 0.63).</p></sec><sec id="j_raon-2019-0022_s_009_w2aab3b7b9b1b6b1aab1c18b4Aa"><h3>Conclusions</h3><p>The presence of DM was not associated with tumor stage, disease-specific survival or overall survival in patients with advanced CRC.</p></sec></abstract>

BackgroundDiabetes mellitus (DM) and DM related comorbidities may initiate difficulties during cancer specific treatment and may have an impact on cancer management and outcome. The aim of our study was to find out if DM in patients with advanced colorectal carcinoma (CRC) is associated with cancer-specific or overall survival.Patients and methodsThis study included 200 consecutive patients (131 males, 69 females, mean age 63 years) with elective CRC surgery at the Institute of Oncology Ljubljana and DM was found in 39 (19.5%) of them. Even 64% of patients had Stage 3 or 4 disease, so neo-adjuvant chemotherapy (CTX) and/or radiotherapy (RT) were carried out in 59% of cases. Data about gender, age, body mass index, presence of DM, American Society of Anesthesiologists (ASA) physical status score, stage of disease and postoperative complications were collected prospectively. Cancer-specific survival and overall survival were compared by log-rank test.ResultsPatients with DM had a higher ASA score, BMI, the illness marker, rate of massive bleeding, blood transfusion and longer hospital stay than those without DM. The mean follow-up period was 4.75 years. All causes mortality in patients with DM and without DM was 23% and 27%, respectively. Three-year cancer-specific survival in patients with DM and without DM was 85% and 89%, respectively (p = 0.68). Three-year overall survival in patients with DM and without DM was 82% and 84%, respectively (p = 0.63).ConclusionsThe presence of DM was not associated with tumor stage, disease-specific survival or overall survival in patients with advanced CRC.

Long term survival in 200 patients with advanced stage of colorectal carcinoma and diabetes mellitus – a single institution experience

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundDiabetes mellitus (DM) and DM related comorbidities may initiate difficulties during cancer specific treatment and may have an impact on cancer...

Characteristic		Without diabetes mellitus (N = 161)	With diabetes mellitus (N = 39)	p-value
Age (years) - mean		62.18 (SD ± 11.8)	65.26 (SD ± 8.9)	0.13
Gender	Male	106	25	0.84
	Female	55	14
American Society of	I	14	0
Anesthesiologists physical status	II	95	10	0.0001
classification score	III	47	29
	IV	5	0
Body mass index (kg/m²) - mean		26.83 (SD ± 4.20)	29.06 (SD ± 4.1)	0.003
	Insulin only	-	5
Treatment of diabetes	Metformin only	-	19	-
	2 or 3 oral antidiabetics	-	15
Phase angle (^o) - mean		5.47 (SD ±1.0)	5.16 (SD ±0.9)	0.11
Illness marker - mean		0.807 (SD ± 0.036)	0.825 (SD ± 0.049)	0.02
Dry lean body mass (kg) - mean		12.97 (SD ± 4.5)	12.65 (SD ± 4.6)	0.72
	Rectum	113	24
Tumor site	Colon	47	13	0.09
	Rectum + Colon	1	2
	0	3	0
	1	21	6
Stage TNM	II	33		0.50
	III	91	18
	IV	13	6
Preoperative radiotherapy	No	67	18
	Yes	94	21	0.61
Preoperative chemotherapy	No	90	22
	Yes	71	17	0.95
Surgical procedure	Low anterior resection	73	13
	Miles + Hartman	38	12	0.38
	Colon resection	50	14
Synchronous resection of liver metastases	No	151	35	0.48
	Yes	10	4
Duration of surgery (min) - mean		175 (SD ±66)	199 (SD ±64)	0.034
Loss of blood (mL) -mean		584 (SD ±497)	813 (SD ±812)	0.027
Postoperative transfusion of
packed red blood cells (mL)		351 (SD ±516)	603 (SD ±665)	0.011
-mean
Postoperative infection (any site)	No	110	22	0.16
	Yes	51	17	0.16
Re-operation	No	153	35	0.21
	Yes	8	4	0.21
Hospital stay (days) -mean		14.4 (SD ±7.6)	19.9 (SD ±10.6)	0.028
	No	111	28
	Locoregional	4	1	0.63
Recurrence (N = 181)	Distant	26	3
	Locoregional + distant	7	1
	Alive	117	30
	Dead of disease	34	7
Outcome	Dead of other causes	9	1	0.74
	Dead - Unknown cause	1	1

Long term survival in 200 patients with advanced stage of colorectal carcinoma and diabetes mellitus – a single institution experience

Article Category: Research Article

Published Online: May 08, 2019

Page range: 238 - 244

Received: Jan 31, 2019

Accepted: Apr 07, 2019

DOI: https://doi.org/10.2478/raon-2019-0022

© 2019 Nikola Besic, Milena Kerin Povsic, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Figure 1

Figure 2

Patient’s characteristics, tumor, treatment and outcome