Survival of Colorectal Cancer Patients With Diabetes Mellitus: A Meta-Analysis

Abstract

We evaluated the prognosis of colorectal cancer in patients with diabetes mellitus. The present meta-analysis involved 82 observational studies (5,267,980 participants). Diagnosis of diabetes was associated with an increased risk of mortality.

Improvement of Diabetes Mellitus After Colorectal Cancer Surgery: A Retrospective Study of Predictive Factors For Type 2 Diabetes Mellitus Remission and Overall Survival

“…BMI, body mass index, T2DM, type 2diabetes mellitus; TNM, Tumor Node Metastasis. before and after CRC surgery would bring survival benefits for patients (11).…”

“…Patients might benefit from dietary adjustments, sodium restriction, more exercise and lower alcohol consumption; therefore, T2DM might improve when the lifestyle of patients is modified after CRC surgery. Pre-existing T2DM patients have a higher rate of developing other second primary malignancies (30), and a worse overall survival after CRC surgery (11,30). A meta-analysis also reported decreased survival and increased risk of relapse in patients with concurrent CRC and T2DM (11).…”

“…Previous studies reported that T2DM could improve the incidence of CRC (8,9), and mortality and complications would increase when patients with concurrent CRC and T2DM underwent CRC surgery (10). Furthermore, T2DM has been shown to have significant effects on chemoresistance, and pre-existing T2DM patients decreases overall survival and increases the risk of relapse survival after CRC surgery as well (11,12).…”

Insulin-Like Growth Factor 1 (IGF-1) Signaling in Glucose Metabolism in Colorectal Cancer

“…Studies show that ~12–20% of diabetic patients are at risk of CRC and the incidence rate is more than twice as high as in other populations [ 22 , 154 ]. Hyperglycemia and DM (mainly type 2) are associated not only with a higher incidence, but also with the progression (including mortality) of CRC [ 155 , 156 , 157 , 158 ], as also confirmed by older and recent meta-analyses [ 159 , 160 , 161 ]. Some authors show that the risk of CRC among obese people with diabetes increases with longer duration of obesity of 4–8 years (HR 1.19; 1.06–1.34) and >8 years (HR: 1.28; 1.11–1.49) [ 157 ].…”

“…Similarly, higher tissue expression of IGF-1 and IGF-1R, as well as lower levels of IGFBP-6 in CRC vs. adjacent healthy tissues were observed [ 162 ]. Concomitant diagnosis of CRC and DM was associated with an increased risk of overall (HR, 1.21; 95% CI, 1.17–1.25) and cancer-specific mortality (CSM) (HR, 1.11; 95% CI, 1.05–1.17), as well as an increased risk of cancer recurrence (HR, 1.09; 95% CI, 1.02–1.16) [ 161 ].…”