Effect of diabetes mellitus comorbidity on outcomes in stages II and III colorectal cancer

Lin, Cheng-Yao; Lin, Chien-Liang; Huang, Wen-Tsung; Peng, Cheau-Jane; Su, Shih‐Bin; Guo, How‐Ran

doi:10.1111/ajco.13639

Cited by 3 publications

(3 citation statements)

References 35 publications

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“…According to Lin et al 2021 [ 27 ] diabetic patients with CRC have a higher mortality rate than non-diabetic patients, and it is critical to control and manage DM-associated disorders in order to improve survival in patients with CRC patients with T2DM. Furthermore, Mills et al 2013 [ 28 ] found that diabetes was linked with a 17% increased risk of all-cause mortality in CRC patients in a meta-analysis of 21 studies.…”

Section: Discussionmentioning

confidence: 99%

Type 2 Diabetes Mellitus and Non-Metastatic Colorectal Cancer: A Retrospective Study on Survival and Toxicity Profiles

Elabd,

Alabassy,

Seddik

et al. 2024

Asian Pac J Cancer Prev

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Background and aims: Being one of the most common cancers accounting for approximately 185 million cases globally, colorectal cancer (CRC) is one of the leading derivers of cancer-related mortalities. A high prevalence of Type 2 diabetes mellitus and CRC was noted, together with a causal link between diabetes and CRC development. Thereby, the goal of this study was to properly evaluate type 2 Diabetes mellitus in non-metastatic colorectal cancer patients, and to highlight its impacts on patient’s outcome. Methods: Patients with non-metastatic colorectal cancer diagnosed between January 2016 and December 2020 were studied retrospectively. Patients were divided into two groups based on whether or not they had type II diabetes. The clinico-pathological, laboratory, treatment and survival data were gathered. Results: A total of 318 patients were included in this study. The toxicity of the drugs used in CRC patients receiving the treatment protocols (169 in non-T2DM group and 39 in T2DM group), both groups reported close percentage of side effects and a similar frequency of drug toxicity occurrence as well as grade of toxicity, with the exception of neuropathy, which was more common in the T2DM group (33.3% vs 11.2%). As for prognosis, non-T2DM and T2DM patients had a mean progression free survival of (71.4 and 60.83 months, respectively) (p = 0.019). Overall survival was 73.1% for T2DM and 85.3% for non T2DM cases. The median overall survival was not reached for both groups in terms of overall survival. Conclusion: T2DM is considered a risk factor for poor survival among CRC patients. Treatment related toxicity is not affected by the presence or absence of diabetes, yet neuropathy needs further studies for diabetic patients receiving oxaliplatin.

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Section: Discussionmentioning

confidence: 99%

Type 2 Diabetes Mellitus and Non-Metastatic Colorectal Cancer: A Retrospective Study on Survival and Toxicity Profiles

Elabd,

Alabassy,

Seddik

et al. 2024

Asian Pac J Cancer Prev

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“…Huh et al [26] proposed a new histological rating to be used in the follow-up of CRC patients, which considers the presence of LVI. Although many studies have shown that DM is associated with poor prognosis in CRC patients, as in all cancers, its effect on LVI remains a matter of debate [27][28][29]. Little information in the literature provides an idea of how LVI is affected in CRC patients with DM.…”

Section: Discussionmentioning

confidence: 99%

Lymphovascular invasion in colorectal cancers: can we predict it preoperatively?

Zarbaliyev,

Turhan,

Çelik

et al. 2024

Ann Coloproctol

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Purpose: This study aimed to investigate preoperative predictors of lymphovascular invasion (LVI), which is a poor prognostic factor usually detected postoperatively in patients with colorectal cancer.Methods: Results for all patients operated on for colorectal cancer between January 1, 2006, and December 31, 2021, were retrospectively analyzed. Potential preoperative factors and postoperative pathology results were recorded. The patients were categorized as those with LVI and those without LVI. Potential factors that may be associated with LVI were compared between the 2 groups.Results: The study included 335 patients. The incidence of LVI was 3.11 times higher in patients with ascending colon tumors (odds ratio [OR], 3.11; 95% confidence interval [CI], 1.34–7.23; P=0.008) and 4.28 times higher in those with metastatic tumors (OR, 4.28; 95% CI, 2.18–8.39; P<0.001). Diabetes mellitus was inversely related to LVI in colorectal cancer patients; specifically, LVI was 56% less common in colorectal cancer patients with diabetes mellitus, irrespective of its duration (OR, 0.44; 95% CI, 0.25–0.76; P<0.001).ConclusionThe presence of preoperative LVI in colorectal cancer patients is difficult to predict. In particular, the effect of the effect of factors such as chronic disease accompanied by microvascular pathologies on LVI is still unclear. Advances in the neoadjuvant treatment of colorectal cancer patients, who are becoming more widespread every day, will encourage the investigation of different methods of preoperatively predicting LVI as a poor prognostic factor in these patients.

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“…In CRC, both hereditary and environmental variables are thought to impact sex and gender disparities. While some studies have found that age and sex have little or no bearing on the risk of death in patients with colorectal cancer [ 43 ], the present study outcome shows gender to be a significant predictor of death (survival) as the male gender has about a three-fold increased risk of dying from colorectal cancer in an at-risk range of 2–9 times (95% CI) than the female patients ( p -value = 0.040). Similar findings have also been reported in several studies [ 44 , 45 , 46 , 47 , 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

The Prediction of Survival Outcome and Prognosis Factor in Association with Comorbidity Status in Patients with Colorectal Cancer: A Research-Based Study

et al. 2022

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Colorectal carcinoma (CRC) is rising exponentially in Asia, representing 11% of cancer worldwide. This study analysed the influence of CRC on patients’ life expectancy (survival and prognosis factors) via clinicopathology data and comorbidity status of CRC patients. Methodology: A retrospective study performed in HUSM using clinical data from the Surgery unit from 2015 to 2020. The demographic and pertinent clinical data were retrieved for preliminary analyses (data cleansing and exploration). Demographics and pathological characteristics were illustrated using descriptive analysis; 5-year survival rates were calculated using Kaplan–Meier methods; potential prognostic variables were analysed using simple and multivariate logistic regression analysis conducted via the Cox proportional hazards model, while the Charlson Comorbidity Scale was used to categorize patients’ disease status. Results: Of a total of 114 CRC patients, two-thirds (89.5%) were from Malay tribes, while Indian and Chinese had 5.3% each. The 50–69.9 years were the most affected group (45.6%). Overall, 40.4% were smokers (majorly male (95.7%)), 14.0% ex-smokers, and 45.6% non-smokers (p-value = 0.001). The Kaplan–Meier overall 5-year median survival time was 62.5%. From the outcomes, patients who were male and >70 years had metastasis present, who presented with per rectal bleeding and were classified as Duke C; and who has tumour in the rectum had the lowest survival rate. Regarding the prognosis factors investigated, “Gender” (adjusted hazard ratio (HR): 2.62; 95% CI: 1.56–7.81, p-value = 0.040), “Presence of metastases” (HR: 3.76; 95% CI: 1.89–7.32, p-value = 0.010), “Metastasis site: Liver” (HR: 5.04; 95% CI: 1.71–19.05, p-value = 0.039), “Lymphovascular permeation” (HR: 2.94; 95% CI: 1.99–5.92, p-value = 0.021), and “CEA-level” (HR: 2.43; 95% CI: 1.49–5.80, p-value = 0.001) remained significant in the final model for multiple Cox proportional hazard regression analyses. There was a significant mean association between tumour grades and the patient’s comorbidity status. Conclusions: Histopathological factors (gender, metastases presence, site of metastases, CEA level, and lymphovascular permeation) showed the best prognosis-predicting factors in CRC.

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Effect of diabetes mellitus comorbidity on outcomes in stages II and III colorectal cancer

Cited by 3 publications

References 35 publications

Type 2 Diabetes Mellitus and Non-Metastatic Colorectal Cancer: A Retrospective Study on Survival and Toxicity Profiles

Type 2 Diabetes Mellitus and Non-Metastatic Colorectal Cancer: A Retrospective Study on Survival and Toxicity Profiles

Lymphovascular invasion in colorectal cancers: can we predict it preoperatively?

The Prediction of Survival Outcome and Prognosis Factor in Association with Comorbidity Status in Patients with Colorectal Cancer: A Research-Based Study

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