title: Effect of Diabetes Mellitus on Survival in Patients with Pancreatic Cancer: A Systematic Review and Meta-analysis.
abstract: Concurrent diabetes has been linked with an increased risk of death in many cancers, but findings in pancreatic cancer have been inconsistent. We performed a systematic review and meta-analysis to assess the effect of diabetes on survival in patients with pancreatic cancer. Of 4, 463 original articles, 41 were included in the review; 29 studies with 33 risk estimates were included in the meta-analysis. In the overall comparison of patients with pancreatic cancer and diabetes with their nondiabetic counterparts, the former had significantly higher all-cause mortality (pooled HR: 1.13; 95% CI: 1.04-1.22). Subgroup analyses showed that diabetes was associated with poor survival in patients with resectable disease (HR: 1.37; 95% CI: 1.15-1.63) but not in those with unresectable disease (HR: 1.07; 95% CI: 0.89-1.29). The HR (95% CI) was 1.52 (1.20-1.93) for patients with new-onset diabetes (≤ 2 years of diabetes duration) and 1.22 (0.83-1.80) for those with longstanding diabetes (> 2 years). Diabetes was associated with higher mortality overall in patients with pancreatic cancer. The effect of diabetes on overall survival was associated with the stages of tumor and the duration of diabetes.
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.|Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.|Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai, China.|Jiangsu Institute of Clinical Immunology, Suzhou, China.
authors.forename: Yixiang
authors.initials: Y
authors.lastname: Mao
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.|Jiangsu Institute of Clinical Immunology, Suzhou, China.
authors.forename: Min
authors.initials: M
authors.lastname: Tao
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Jia
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Oncology, The First Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Chen
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Hongwei
authors.initials: H
authors.lastname: Tang
authors.affiliation: Department of Gastrointestinal Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
authors.forename: Donghui
authors.initials: D
authors.lastname: Li
mesh_terms: D016208:Databases, Factual; D003920:Diabetes Mellitus / Q000473:pathology*; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D010190:Pancreatic Neoplasms / Q000150:complications / Q000175:diagnosis / Q000401:mortality*; D016016:Proportional Hazards Models; D012306:Risk