Abstract
PurposeThe purpose of the current study was to evaluate the impact of colorectal cancer (CRC) surgery on type 2 diabetes mellitus (T2DM) and to analyze the change in T2DM on overall survival after CRC surgery.MethodsPatients who underwent CRC surgery were retrospectively enrolled from January 2013 to December 2019. The status of T2DM pre- and 1-year after CRC surgery was recorded, and predictive factors for T2DM remission and overall survival were analyzed.ResultsA total of 296 patients were included in this study. Thirty-eight patients experienced remission of T2DM 1 year after CRC surgery, and the remission rate was 12.8%. Weight loss was significantly higher in the T2DM remission group (p = 0.038), and the T2DM duration was significantly shorter in the T2DM remission group (p = 0.015). In the multivariate logistic regression analysis, higher weight loss (p = 0.046, odds ratio = 1.060, 95% CI = 1.001–1.122) and shorter T2DM duration (p = 0.019, odds ratio = 1007, 95% CI = 1.001–1.014) were predictive factors for remission of T2DM. Furthermore, in multivariate Cox regression analysis, lower TNM stage (p = 0.000, odds ratio = 2.147, 95% CI = 1.474–3.128) and T2DM remission (p = 0.033, odds ratio = 2.999, 95% CI = 1.091–8.243) were the predictive factors for better overall survival.ConclusionPatients with concurrent CRC and T2DM had a 12.8% remission 1 year after CRC surgery. Higher weight loss and shorter T2DM duration contributed to T2DM remission, and patients with T2DM remission could improve in terms of their overall survival.
Highlights
Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related death in the world [1]
A total of 296 patients who had concurrent CRC and type 2 diabetes mellitus (T2DM) were included in this study, and the glycemic status in the studied patients was stable before and 1 year after CRC surgery
Weight loss was significantly higher in the T2DM remission group, and T2DM duration was significantly shorter in the T2DM remission group
Summary
Colorectal cancer (CRC) is the third most common cancer and the second leading cause of cancer-related death in the world [1]. The 5-year overall survival rates of colon cancer and rectal cancer are approximately 60 and 55%, respectively, in nonmetastatic CRC [2], and surgery is currently the most effective treatment for CRC [3]. The prevalence of type 2 diabetes mellitus (T2DM) is rapidly increasing worldwide [4]. 400 million people suffer from T2DM, and it is estimated that 650 million cases of T2DM will be diagnosed by 2040 [5]. A national survey conducted in 2010 stated that the incidence of T2DM had risen to 11.6%, of which only 25.8% had received conventional treatment, and only 39.7% was well controlled in China [7]
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