title: Outcome after curative surgery for gastric cancer patients with type 2 diabetes.
abstract: BACKGROUND
  Bariatric surgery has been adapted to the management of morbid obesity, leading to not only loss of body weight but also improvement of type 2 diabetes mellitus (DM). The goal of our study was to evaluate the effect of gastrectomy in gastric cancer patients with type 2 DM.
  
  
  METHODS
  From 1989 to 2011, a total of 69 gastric cancer patients receiving curative surgery were enrolled in this study. They were diagnosed with type 2 DM preoperatively and all are alive without tumor recurrence. The clinical characteristics were compared between groups with improved or unimproved DM, and groups were also analyzed based on the extent of gastrectomy and different reconstruction methods.
  
  
  RESULTS
  Of the 69 patients, 58 received subtotal gastrectomy and 11 received total gastrectomy. The frequency of DM improvement was significantly higher after total gastrectomy than subtotal gastrectomy (81.8 vs. 36.2 %; p = 0.007). Patients with DM duration of less than 5 years tended to experience DM improvement after surgery more frequently than patients with DM duration of more than 5 years (p = 0.028). Roux-en-Y esophagojejunostomy (R-Ye) led to a higher rate of DM improvement than did R-Y gastrojejunostomy (R-Yg), especially in patients with DM duration more than 5 years. Among patients receiving duodenal bypass after gastrectomy, R-Ye was associated with a higher frequency of DM improvement than R-Yg and B-II.
  
  
  CONCLUSIONS
  The extent of gastrectomy rather than the reconstruction method played an important role in DM improvement after curative surgery for gastric cancer.
authors.affiliation: Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, 201 Section 2 Shih-Pai Road, Taipei, 11217, Taiwan.
authors.forename: Kuo-Chung
authors.initials: KC
authors.lastname: Wang
authors.forename: Kuo-Hung
authors.initials: KH
authors.lastname: Huang
authors.forename: Yuan-Tzu
authors.initials: YT
authors.lastname: Lan
authors.forename: Wen-Liang
authors.initials: WL
authors.lastname: Fang
authors.forename: Su-Shun
authors.initials: SS
authors.lastname: Lo
authors.forename: Anna Fen-Yau
authors.initials: AF
authors.lastname: Li
authors.forename: Chew-Wun
authors.initials: CW
authors.lastname: Wu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D050110:Bariatric Surgery; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000601:surgery*; D005163:Factor Analysis, Statistical; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000601:surgery*; D016896:Treatment Outcome