Abstract

PurposeThe current study aims to explore the outcomes of type 2 diabetes mellitus (T2DM) on gastric cancer patients following gastrectomy through propensity score matching (PSM) analysis.MethodsA retrospective study of gastric cancer patients following gastrectomy was conducted in a single clinical center from January 2014 to December 2019. The short-term outcomes, overall survival (OS) and disease-free survival (DFS) were analyzed between T2DM group and Non-T2DM group.ResultsA total of 703 patients were enrolled in this study. After 1:1 PSM, 84 patients in T2DM group and 84 patients in Non-T2DM were matched for final analysis. No significant difference was found in terms of operation time, intra-operative blood loss, retrieved lymph nodes, postoperative stay, blood transfusion and complications between T2DM group and Non-T2DM group (p > 0.05). The Kaplan-Meier curve implied that T2DM had no impact on OS or DFS. Cox regression was conducted to identify predictive factors for prognosis. Body mass index (BMI) (p = 0.039 < 0.05, HR = 0.725, 95% CI = 0.534–0.983), pre-operative lymphocyte (p = 0.017 < 0.05, HR = 0.678, 95% CI = 0.493–0.932), pathological tumor node metastasis (pTNM) stage (p = 0.000 < 0.05, HR = 2.619, 95% CI = 2.048–3.349) and complications (p = 0.006 < 0.05, HR = 1.528, 95% CI = 1.132–2.061) were predictive factors for OS, and BMI (p = 0.013 < 0.05, HR = 0.524, 95% CI = 0.315–0.872), pTNM stage (p = 0.000 < 0.05, HR = 2.619, 95% CI = 2.048–3.349) and complications (p = 0.008 < 0.05, HR = 1.892, 95% CI = 1.179–3.036) were independent predictive factors for DFS.ConclusionT2DM did not have an impact on gastric cancer patients following gastrectomy in terms of short-term outcomes and prognosis.

Highlights

  • Gastric cancer is the fifth most common cancer worldwide and the third leading cause of cancer-related deaths [1, 2]

  • The current study aims to explore the outcomes of type 2 diabetes mellitus (T2DM) on gastric cancer patients following gastrectomy through propensity score matching (PSM) analysis

  • After 1:1 PSM, 84 patients in Type 2 diabetes mellitus (T2DM) group and 84 patients in Non-T2DM were matched for final analysis

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Summary

Introduction

Gastric cancer is the fifth most common cancer worldwide and the third leading cause of cancer-related deaths [1, 2]. More than one million gastric cancer cases were newly diagnosed worldwide each year, of which 44% were diagnosed in China [1, 3]. Type 2 diabetes mellitus (T2DM) is a metabolic disease with a high incidence worldwide, and it is one of the leading causes of death in the world [6]. It has been reported that T2DM could increase the incidence of gastric cancer [9, 10], the impact of T2DM on prognosis after gastrectomy remained controversial [11, 12]. There were few studies using PSM analysis to explore the effect of T2DM on gastrectomy [12, 14]. The current study aims to explore the outcomes of T2DM on gastric cancer patients following gastrectomy through PSM

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