The online version of this article (doi:10.1186/1477-7819-10-76) contains supplementary material, which is available to authorized users.
Ching-Wen Huang, Li-Chu Sun contributed equally to this work.
The authors declare that they have no competing interest.
CWH and LCS analyzed the data and wrote the manuscript. YLS, HLT, CWC, YSY, CJM, and CJH made substantial contributions to data acquisition, statistical analyses and data interpretation, and helped in manuscript preparation. JYW participated in study design and coordination. All authors read and approved the final manuscript.
Both colorectal cancer (CRC) and diabetes mellitus (DM) are important public health problems worldwide. As there are controversies about survival impact on CRC patients with preexisting DM, the purpose of the present study is to evaluate the incidence and the survival impact of preexisting DM on the long-term outcomes of patients with CRC in Taiwan.
From January 2002 to December 2008, 1,197 consecutive patients with histologically proven primary CRC, who received surgical treatment at a single institution, were enrolled. The clinicopathologic features between these patients with and without DM were retrospectively investigated. Moreover, we intended to analyze the impact of DM on overall survival (OS) and cancer-specific survival (CSS) rates.
Of 1,197 CRC patients, 23.6% of patients had either a reported history of DM or were currently taking one or more diabetes-controlling medications. CRC patients with DM were significantly older than those without DM (P < 0.001), and had a higher incidence of cardiac disease and higher body mass index than those without DM (both P < 0.001). There were no significant differences in gender, tumor size, tumor location, histological type, AJCC/UICC cancer stage, vascular invasion, perineural invasion, comorbidity of pulmonary disease or renal disease, and OS, and CSS between two groups. Additionally, DM patients had a higher incidence of second malignancy than patients without DM (9.54% vs 6.01%, P = 0.040).
A considerably high prevalence of DM in CRC patients but no significant impact of DM on survival was observed in the single-institution retrospective study, regardless of cancer stages and tumor locations. Therefore, treatment strategies for CRC patients with DM should be the same as patients without DM.
Additional file 1: Figure S1. Overall survival for CRC patients by tumor location between diabetes and non-diabetes status. (TIFF 92 KB)
Additional file 2: Figure S2. Cancer-specific survival for CRC patients by tumor location between diabetes and non-diabetes status. (TIFF 96 KB)
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