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PLoS One. 2013;8(2):e55196. doi: 10.1371/journal.pone.0055196. Epub 2013 Feb 6.

Impact of diabetes on oncologic outcome of colorectal cancer patients: colon vs. rectal cancer.

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1
Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.

Abstract

BACKGROUND:

To evaluate the impact of diabetes on outcomes in colorectal cancer patients and to examine whether this association varies by the location of tumor (colon vs. rectum).

PATIENTS AND METHODS:

This study includes 4,131 stage I-III colorectal cancer patients, treated between 1995 and 2007 (12.5% diabetic, 53% colon, 47% rectal) in South Korea. Cox proportional hazards modeling was used to determine the prognostic influence of DM on survival endpoints.

RESULTS:

Colorectal cancer patients with DM had significantly worse disease-free survival (DFS) [hazard ratio (HR) 1.17, 95% confidence interval (CI): 1.00-1.37] compared with patients without DM. When considering colon and rectal cancer independently, DM was significantly associated with worse overall survival (OS) (HR: 1.46, 95% CI: 1.11-1.92), DFS (HR: 1.45, 95% CI: 1.15-1.84) and recurrence-free survival (RFS) (HR: 1.32, 95% CI: 0.98-1.76) in colon cancer patients. No association for OS, DFS or RFS was observed in rectal cancer patients. There was significant interaction of location of tumor (colon vs. rectal cancer) with DM on OS (P = 0.009) and DFS (P = 0.007).

CONCLUSIONS:

This study suggests that DM negatively impacts survival outcomes of patients with colon cancer but not rectal cancer.

PMID:
23405123
PMCID:
PMC3566217
DOI:
10.1371/journal.pone.0055196
[Indexed for MEDLINE]
Free PMC Article
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