title: Type 2 diabetes mellitus is associated with increased mortality in Chinese patients receiving curative surgery for colon cancer.
abstract: BACKGROUND
  We investigated the association between diabetes mellitus (DM) and the prognosis of patients with early colon cancer who had undergone curative surgery.
  
  
  METHODS
  From three national databases of patients in Taiwan, we selected a cohort of colon cancer patients who had been newly diagnosed with stage I or stage II colon cancer between January 1, 2004 and December 31, 2008 and had undergone curative surgery. We collected information regarding DM (type 2 DM only), the use of antidiabetic medications, other comorbidities, and survival outcomes. The colon cancer-specific survival (CSS) and the overall survival (OS) were compared between patients with and without DM.
  
  
  RESULTS
  We selected 6,937 colon cancer patients, among whom 1,371 (19.8%) had DM. The colon cancer patients with DM were older and less likely to receive adjuvant chemotherapy but had a similar tumor stage and grade, compared with colon cancer patients without DM. Compared with colon cancer patients without DM, patients with DM had significantly shorter OS (5-year OS: 71.0% vs. 81.7%) and CSS (5-year CSS: 86.7% vs. 89.2%). After adjusting for age, sex, stage, adjuvant chemotherapy, and comorbidities in our multivariate analysis, DM remained an independent prognostic factor for overall mortality (adjusted hazards ratio: 1.32, 95% confidence interval: 1.18-1.49), but not for cancer-specific mortality. Among the colon cancer patients who had received antidiabetic drug therapy, patients who had used insulin had significantly shorter CSS and OS than patients who had not.
  
  
  CONCLUSIONS
  Among patients who receive curative surgery for early colon cancer, DM is a predictor of increased overall mortality.
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Kuo-Hsing
authors: KH
authors: Chen
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Yu-Yun
authors: YY
authors: Shao
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Zhong-Zhe
authors: ZZ
authors: Lin
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Yi-Chun
authors: YC
authors: Yeh
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Wen-Yi
authors: WY
authors: Shau
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Raymond Nienchen
authors: RN
authors: Kuo
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Ho-Min
authors: HM
authors: Chen
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Chiu-Ling
authors: CL
authors: Lai
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Kun-Huei
authors: KH
authors: Yeh
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China.
authors: Ann-Lii
authors: AL
authors: Cheng
authors: Department of Oncology, National Taiwan University Hospital, Yun-Lin Branch, Yunlin, Taiwan, Republic of China; Department of Oncology and Center for Comparative Effectiveness Research, National Center of Excellence for Clinical Trial and Research, National Taiwan University Hospital, Taipei, Taiwan, Republic of China; Graduate Institutes of Oncology and Clinical Medicine and Department of Internal Medicine, National Taiwan University College of Medicine, Taipei, Taiwan, Republic of China; Institutes of Health Policy and Management and Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan, Republic of China mslai@cph.ntu.edu.tw.
authors: Mei-Shu
authors: MS
authors: Lai
mesh_terms: D000328:Adult; D000368:Aged; D003110:Colonic Neoplasms / Q000150:complications / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015897:Comorbidity; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000401:mortality* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007004:Hypoglycemic Agents / Q000009:adverse effects / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D013624:Taiwan
chemical_list: D007004:Hypoglycemic Agents
keywords: Cancer registry; Colorectal cancer; Diabetes mellitus; Prognosis