The Impact of Comorbid Diabetes on Short-Term Postoperative Outcomes in Stage I/II Colon Cancer Patients Undergoing Open Colectomy

Abstract

Purpose. This study aimed at evaluating the impact of comorbid diabetes on short-term postoperative outcomes in patients with stage I/II colon cancer after open colectomy. Methods. The data were extracted from the National Inpatient Sample database (2005-2010). Short-term surgical outcomes included in-hospital mortality, postoperative complications, and hospital length of stay. Results. A total of 49,064 stage I/II colon cancer patients undergoing open surgery were included, with a mean age of 70.35 years. Of them, 21.94% had comorbid diabetes. Multivariable analyses revealed that comorbid diabetes was significantly associated with a lower risk of in-hospital mortality and postoperative complications. Compared to patients without diabetes, patients with uncomplicated diabetes had lower percentages of in-hospital mortality and postoperative complications, but patients with complicated diabetes had a higher percentage of postoperative complications. In addition, patients with diabetes only, but not patients with diabetes and hypertension only, had a lower percentage of in-hospital mortality than patients without any comorbidity. Conclusion. The present results suggested the protective effects of uncomplicated diabetes on short-term surgical outcomes in stage I/II colon cancer patients after open colectomy. Further studies are warranted to confirm these unexpected findings and investigate the possible underlying mechanisms.

Impact of preoperative type 2 diabetes mellitus on the outcomes of patients with gastric cancer following gastrectomy: Analysis of 834 patients using propensity score matching

“…Zylla et al (25) reported that T2DM was associated with higher infection and readmission rates. Other studies also showed that T2DM was associated with increased postoperative complications, for example, anastomotic leakage and hemorrhage (12,25,26). The possible mechanism was as follows: i) Glycolysis is highly dependent on glucose, and a number of tumour cells rely on glycolysis for energy supply while in the state of hyperglycemia, making uncontrolled hyperglycemia beneficial to cancer cell proliferation (27); and ii) chronic inflammatory disease, such as T2DM, may result in malignant tumors (28).…”

Impact of Preoperative Type 2 Diabetes Mellitus on the Outcomes of Gastric Cancer Patients Following Gastrectomy: A Propensity Score Matching Analysis

“…A recent study reported that T2DM was associated with increased infection and readmission rate ( 23 ). Lee et al ( 24 ) reported T2DM could increase the postoperative complications, postoperative stay, combined with other diseases and the status of hyperglycemia might contribute to the complications. However, in our study, it was found no statistical difference in terms of postoperative stay or complications, which was consistent with previous studies ( 25 ).…”

Glycemic Variability in Patients With Stage II–III Colon Cancer Treated With Surgery and Adjuvant Chemotherapy

“…Therefore, glycemic control is essential for improving outcomes in patients with cancer. The incidence of T2D in the U.S. general population is 10.5% (Centers for Disease Control and Prevention, 2020), yet diabetes (types 1 and 2) have been reported to occur in 21.94% of patients with early-stage (stage I-II) colon cancer (Lee et al, 2020). Importantly, prior to a cancer diagnosis, patients with T2D have a 27% higher risk of developing colon cancer, the fourth most diagnosed cancer in the United States (American Cancer Society, 2021), compared to individuals without T2D (González et al, 2017).…”