Impact of type 2 diabetes mellitus on short‐term and long‐term outcomes of patients with esophageal squamous cell cancer undergoing resection: a propensity score analysis

Abstract

BackgroundThe association between type 2 diabetes mellitus (T2DM) and the risk of esophageal cancer remains unclear. The present study aimed to evaluate the impact of T2DM on short-term outcomes and long-term survival in patients with esophageal squamous cell cancer (ESCC).MethodsThe present retrospective study included 862 patients diagnosed with ESCC between January 2001 and December 2010. Among them, 280 patients had T2DM. A 1:1 propensity score-matched cohort consisting of 280 patients with and 280 without T2DM was selected from the 862 patients. The associations between T2DM and clinicopathologic characteristics were assessed using the χ2 or Fisher’s exact test. Survival of ESCC patients with and without T2DM was calculated by using the Kaplan–Meier method and compared by using the Cox regression model between the two groups.ResultsThe occurrence rate of anastomotic leakage was significantly higher in patients with T2DM than in those without T2DM (P < 0.001). In the subgroup with weight loss rate ≤ 5.05%, ESCC patients with T2DM had a significant longer overall survival than did those without T2DM (P = 0.003), whereas in the subgroup with weight loss rate > 5.05%, the patients without T2DM showed a longer survival (P = 0.001). Univariate and multivariate analysis results showed that T2DM was not an independent prognostic factor for patient survival.ConclusionsType 2 diabetes mellitus is not an independent prognostic factor in patients with ESCC. However, the combination of T2DM with severe weight loss would be a predictor of poor prognosis.

Glycemic Control and Survival of Patients With Coexisting Diabetes Mellitus and Gastric Or Esophageal Cancer

“…Certain comorbidities, such as atrial fibrillation and hypothyroidism, have affected esophageal cancer survival [20]. Among patients with esophagectomy for squamous cell cancer, OS is shorter for patients with DM and weight loss [21].…”

Gender Differences in Factors Associated with Clinically Meaningful Weight Loss among Adults Who Were Overweight or Obese: A Population-Based Cohort Study

“…Its prevalence in adults has increased from 21% in men and 24% in women to almost 40% in both genders, in the past 4 decades [1]. Excess body weight increases the risk of chronic diseases, such as cardiovascular diseases [2], diabetes mellitus [3], musculoskeletal disorders [4], and cancers [5, 6]. Clinically meaningful weight loss (cmWL), defined as more than 5% weight loss from initial body weight, has been associated with significant health benefits among adults, such as a decreased risk of chronic health conditions (e.g., diabetes, hypertension, cancers) and mortality [7-9].…”

Safety analysis of early oral feeding after esophagectomy in patients complicated with diabetes

“…At present, about 10% ~ 20% of surgical patients are accompanied with diabetes, mainly type II diabetes [ 6 ]. For patients of esophageal cancer accompanied with type II diabetes, postoperative complications such as difficult incision healing, pulmonary infection and anastomotic fistula are more likely to occur, which remarkably increases the risk of complications after surgery [ 7 – 9 ]. It is of great significance to reduce the surgical risk of this group of patients.…”