Improving outcome prediction in individuals with colorectal cancer and diabetes by accurate assessment of vascular complications: Implications for clinical practice

Birch, Rebecca; Downing, Amy; Finan, P. J.; Howell, Simon; Ajjan, Ramzi; Morris, Eva

doi:10.1016/j.ejso.2020.10.033

Cited by 13 publications

(11 citation statements)

References 20 publications

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“…In addition, we found that diabetes was an independent risk factor for recurrence, especially for systemic recurrence. The similar results were previously reported in the epithelial ovarian cancer [ 10 , 17 ], pancreatic cancer [ 8 , 18 ], breast cancer [ 7 ], gallbladder cancer [ 9 ], colorectal cancer [ 13 , 19 , 20 ], and non-small-cell lung cancer [ 15 ]. However, the exact mechanism of how diabetes affects the prognosis of AC patients who underwent curative pancreaticoduodenectomy remains unclear.…”

Section: Discussionsupporting

confidence: 89%

“…Secondly, AC patients with diabetes in the current study were more likely to present with a later stage compared with those without diabetes ( p = 0.05). Thirdly, a previous study found that perhaps diabetes complications were the main reason for the poor prognosis of colorectal cancer patients rather than diabetes itself by accurately assessing diabetes complications [ 20 ]. The results might indicate that prognosis of AC patients who have a prolonged diabetes history is more likely to be affected by diabetes complications.…”

Section: Discussionmentioning

confidence: 99%

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Impact of Diabetes on Short-Term and Long-Term Outcomes of Ampullary Adenocarcinoma Patients after Curative Pancreatoduodenectomy

Zhang

Sun

et al. 2022

Current Oncology

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Background: Many studies have confirmed that diabetes was associated with prognosis in many malignant cancer types. However, the impact of diabetes on ampullary carcinoma (AC) has not been investigated. Methods: A total of 266 AC patients in the National Cancer Center of China between January 1998 and December 2020 were retrospectively reviewed. The postoperative complication rate, postoperative recurrence rate, and long-term survival were compared between the diabetes group and the no diabetes group. Results: A total of 32 AC patients (12.03%) were diagnosed with diabetes before surgery. In total, 111 patients (41.73%) had one or more postoperative complications, and there was no perioperative death. There was no statistically significant difference regarding postoperative complications between the diabetes group and the no diabetes group. Altogether, 120 patients (45.11%) experienced postoperative recurrence. Multivariate analysis revealed that diabetes was an independent risk factor for the recurrence (OR: 2.384, 95% CI: 1.065–5.336, p = 0.035), OS (HR: 1.597, 95% CI: 1.005–2.537, p = 0.047), and RFS (HR: 1.768, 95% CI: 1.068–2.925, p = 0.027) in AC patients after curative pancreatoduodenectomy. Conclusions: Diabetes may adversely affect the recurrence of patients with AC after curative pancreaticoduodenectomy, leading to an increased risk of poor prognosis in early-stage patients. Further studies involving a large sample size are needed to validate our results.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Impact of Diabetes on Short-Term and Long-Term Outcomes of Ampullary Adenocarcinoma Patients after Curative Pancreatoduodenectomy

Zhang

Sun

et al. 2022

Current Oncology

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“…This has been explored by our group in colorectal cancer, suggesting that presence of complications is associated with both postoperative mortality (90-day) and death during the surgical episode. 84 …”

Section: Discussionmentioning

confidence: 99%

Diabetes mellitus and perioperative outcomes: a scoping review of the literature

Drayton

Birch

D'Souza-Ferrer

et al. 2022

British Journal of Anaesthesia

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“…Third, although we collected information on body mass indices, we did not have data available on visceral adiposity and muscle radio-density which have been shown to be associated with increased risk of MACCE in colorectal cancer patients [ 30 ]. Lastly, although data on diabetes including medications and glucose concentrations were available, data on diabetic complications was not available which has been associated with adverse post-operative outcomes in colorectal cancer surgery instead of diabetes itself [ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Chemotherapy and adverse cardiovascular events in colorectal cancer patients undergoing surgical resection

et al. 2021

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Background Colorectal cancer patients undergoing surgical resection are at increased short-term risk of post-operative adverse events. However, specific predictors for long-term major adverse cardiac and cerebrovascular events (MACCE) are unclear. We hypothesised that patients who receive chemotherapy are at higher risk of MACCE than those who did not. Methods In this retrospective study, 412 patients who underwent surgical resection for newly diagnosed colorectal cancer from January 2013 to April 2015 were grouped according to chemotherapy status. MACCE was defined as a composite of cardiovascular death, myocardial infarction, stroke, unplanned revascularisation, hospitalisation for heart failure or angina. Predictors of MACCE were identified using competing risks regression, with non-cardiovascular death a competing risk. Results There were 200 patients in the chemotherapy group and 212 patients in the non-chemotherapy group. The overall prevalence of prior cardiovascular disease was 20.9%. Over a median follow-up duration of 5.1 years from diagnosis, the incidence of MACCE was 13.3%. Diabetes mellitus and prior cardiovascular disease were associated with an increased risk of MACCE (subdistribution hazard ratio, 2.56; 95% CI, 1.48-4.42) and 2.38 (95% CI, 1.36-4.18) respectively. The chemotherapy group was associated with a lower risk of MACCE (subdistribution hazard ratio, 0.37; 95% CI, 0.19-0.75) compared to the non-chemotherapy group. Conclusions Amongst colorectal cancer patients undergoing surgical resection, there was a high incidence of MACCE. Diabetes mellitus and prior cardiovascular disease were associated with an increased risk of MACCE. Chemotherapy was associated with a lower risk of MACCE, but further research is required to clarify this association.

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Improving outcome prediction in individuals with colorectal cancer and diabetes by accurate assessment of vascular complications: Implications for clinical practice

Cited by 13 publications

References 20 publications

Impact of Diabetes on Short-Term and Long-Term Outcomes of Ampullary Adenocarcinoma Patients after Curative Pancreatoduodenectomy

Impact of Diabetes on Short-Term and Long-Term Outcomes of Ampullary Adenocarcinoma Patients after Curative Pancreatoduodenectomy

Diabetes mellitus and perioperative outcomes: a scoping review of the literature

Chemotherapy and adverse cardiovascular events in colorectal cancer patients undergoing surgical resection

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