title: Impact of diabetes on oncologic outcome of colorectal cancer patients: colon vs. rectal cancer.
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).
  
  
  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.
authors: Department of Medical Oncology, Dana Farber Cancer Institute, Harvard Medical School, Boston, MA, USA.
authors: Justin Y
authors: JY
authors: Jeon
authors: Duck Hyoun
authors: DH
authors: Jeong
authors: Min Geun
authors: MG
authors: Park
authors: Ji-Won
authors: JW
authors: Lee
authors: Sang Hui
authors: SH
authors: Chu
authors: Ji-Hye
authors: JH
authors: Park
authors: Mi Kyung
authors: MK
authors: Lee
authors: Kaori
authors: K
authors: Sato
authors: Jennifer A
authors: JA
authors: Ligibel
authors: Jeffrey A
authors: JA
authors: Meyerhardt
authors: Nam Kyu
authors: NK
authors: Kim
mesh_terms: D000368:Aged; D015331:Cohort Studies; D003110:Colonic Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D015179:Colorectal Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D016001:Confidence Intervals; D003920:Diabetes Mellitus / Q000401:mortality* / Q000503:physiopathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012004:Rectal Neoplasms / Q000188:drug therapy* / Q000401:mortality*; D056910:Republic of Korea / Q000453:epidemiology; D016896:Treatment Outcome
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