Effect of Diabetes Mellitus on Survival in Patients with Pancreatic Cancer: A Systematic Review and Meta-analysis

Mao, Yiming; Tao, Min; Jia, Xiaoyan; Xu, Hong; Chen, Kai; Tang, Hongwei; Li, Donghui

doi:10.1038/srep17102

Cited by 39 publications

(48 citation statements)

References 65 publications

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“…Taken together our data suggest that pre-operative recent-onset DM, but not long-lasting DM or post-operative new-onset DM, has an impact on the prognosis of PDAC. Our results are in agreement with a recent meta-analysis reporting that preexisting DM in PDAC is associated with increased risk of mortality [57]. Of note, the meta-analysis showed that the risk of mortality was higher in patients with resected or resectable cancer than in those with nonresectable cancer and was higher in patients with recent-onset DM than in those with long-lasting DM [57].…”

Section: Discussionsupporting

confidence: 92%

Effect of Diabetes on Survival after Resection of Pancreatic Adenocarcinoma. A Prospective, Observational Study

et al. 2016

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AimTo investigate the effect of diabetes mellitus (DM) on disease-free and overall post-resection survival of patients with pancreatic ductal adenocarcinoma (PDAC)MethodsProspective observational study on patients admitted for pancreatic disease from January 2008 to October 2012. DM was classified as recent-onset (<48 months before PDAC diagnosis), longstanding (≥48 months before PDAC) or new onset (after surgery).ResultsOf 296 patients, 140 had a diagnosis of DM prior to surgery (26 longstanding, 99 recent-onset, 15 with unknown duration). Median follow-up time was 5.4 ± 0.22 years. Patients with recent onset DM had poorer postoperative survival than patients without DM: disease-free survival and overall survival were 1.14±0.13 years and 1.52±0.12 years in recent onset DM, versus 1.3±0.15 years and 1.87±0.15 years in non-diabetic patients (p = 0.013 and p = 0.025, respectively). Longstanding DM and postoperative new onset DM had no impact on prognosis. Compared to cases without DM, patients with recent onset DM were more likely to have residual disease after surgery and to develop liver metastases during follow-up. Multivariate analysis confirmed recent onset DM was independently associated with PDAC relapse (hazard ratio 1.45 [1.06–1.99]).ConclusionPreoperative recent onset DM has an impact on survival after the resection of PDAC.

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Section: Discussionsupporting

confidence: 92%

Effect of Diabetes on Survival after Resection of Pancreatic Adenocarcinoma. A Prospective, Observational Study

et al. 2016

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“…Our analysis revealed that with T2DM have about a 5 % higher risk of CRA than newly diagnosed diabetes patients, revealing the duration of T2DM as a risk factor for CRA. A possible explanation is that known T2DM patients’ bowels are exposed to hyperinsulinemia or a hyperglycemic environment for a longer time, and such hormonal or metabolic abnormalities (according to former study [ 60 ]) could affect tumour growth. However, some studies reported that metformin use was a protective factor of CRA [ 33 ] and cancer [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Type 2 diabetes mellitus and risk of colorectal adenoma: a meta-analysis of observational studies

Yu¹,

Guo

Wang

et al. 2016

BMC Cancer

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BackgroundTo summarize the relationship between type 2 diabetes mellitus (T2DM) and risk of colorectal adenomas (CRA), we performed a meta-analysis of observational studies.MethodsTo find studies, we searched PubMed, Embase, the Cochrane Library, Web of Science and conference abstracts and related publications for American Society of Clinical Oncology and the European Society of Medical Oncology. Studies that reported relative risks (RRs) or odds ratios (ORs) with 95 % confidence intervals (CIs) for the association between T2DM and risk of CRA were included. The meta-analysis assessed the relationships between T2DM and risk of CRA. Sensitivity analyses were performed in two ways: (1) by omitting each study iteratively and (2) by keeping high-quality studies only. Publication bias was detected by Egger’s and Begg’s tests and corrected using the trim and fill method.ResultsThis meta-analysis included 17 studies with 28,999 participants and 6798 CRA cases. We found that T2DM was a risk factor for CRA (RR: 1.52; 95 % CI: 1.29–1.80), and also for the advanced adenoma (RR: 1.41; 95 % CI: 1.06–1.87). Patients with existing T2DM (RR: 1.56; 95 % CI: 1.16–2.08) or newly diagnosed T2DM (RR: 1.51; 95 % CI: 1.16–1.97) have a risk of CRA. Similar significant results were found in retrospective studies (RR: 1.57; 95 % CI: 1.30–1.89) and population based cross-sectional studies (RR: 1.46; 95 % CI: 1.21–1.89), but not in prospective studies (RR: 1.27; 95 % CI: 0.77–2.10).ConclusionsOur results suggested that T2DM plays a risk role in the risk of developing CRA. Consequently, medical workers should increase the rate of CRA screening for T2DM patients so that they can benefit from behavioural interventions that can help prevent the development of colorectal cancer. Additional, large prospective cohort studies are needed to make a more convincing case for these associations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12885-016-2685-3) contains supplementary material, which is available to authorized users.

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“…Such findings emphasise the need to distinguish the significance of aetiological factors that are shared by both PC and DM. There is also a need to investigate the impact of [6,8].…”

Section: Discussionmentioning

confidence: 99%

Exploring the bi-directional relationship between pancreatic cancer and diabetes mellitus: a retrospective study

Harry

Kein-Leong

2018

J Diabetes Metab Disord

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Objective To explore the bi-directional between pancreatic cancer (PC) and diabetes mellitus (DM); focusing on the prevalence, temporal association and impact on survival outcomes. Methods A retrospective audit of pancreatic cancer patients from the institutional clinical database (CaNISC) between January 2012 and April 2018. Results A total of 131 patients were analysed, 58 patients carried a diagnosis of diabetes mellitus. The median overall survival for diabetes mellitus patients was 12.0 months (95 CI, 5.9 to 18.1 months) in comparison to 13.0 months (95% CI, 8.6 to 17.3 months) in non-diabetes mellitus patients (p = 0.334). Conclusion There was no significant difference in the overall survival between DM and non-DM patients.

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Effect of Diabetes Mellitus on Survival in Patients with Pancreatic Cancer: A Systematic Review and Meta-analysis

Cited by 39 publications

References 65 publications

Effect of Diabetes on Survival after Resection of Pancreatic Adenocarcinoma. A Prospective, Observational Study

Effect of Diabetes on Survival after Resection of Pancreatic Adenocarcinoma. A Prospective, Observational Study

Type 2 diabetes mellitus and risk of colorectal adenoma: a meta-analysis of observational studies

Exploring the bi-directional relationship between pancreatic cancer and diabetes mellitus: a retrospective study

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