The Impact of Comorbid Diabetes on Short-Term Postoperative Outcomes in Stage I/II Colon Cancer Patients Undergoing Open Colectomy.

Ko-Chao Lee,Ling-Chiao Song,Kuan-Chih Chung,Hong-Hwa Chen,Kuen-Lin Wu,Kung-Chuan Cheng,Wan-Hsiang Hu

doi:10.1155/2020/2716395

Abstract

Purpose This study aimed at evaluating the impact of comorbid diabetes on short-term postoperative outcomes in patients with stage I/II colon cancer after open colectomy. Methods The data were extracted from the National Inpatient Sample database (2005-2010). Short-term surgical outcomes included in-hospital mortality, postoperative complications, and hospital length of stay. Results A total of 49,064 stage I/II colon cancer patients undergoing open surgery were included, with a mean age of 70.35 years. Of them, 21.94% had comorbid diabetes. Multivariable analyses revealed that comorbid diabetes was significantly associated with a lower risk of in-hospital mortality and postoperative complications. Compared to patients without diabetes, patients with uncomplicated diabetes had lower percentages of in-hospital mortality and postoperative complications, but patients with complicated diabetes had a higher percentage of postoperative complications. In addition, patients with diabetes only, but not patients with diabetes and hypertension only, had a lower percentage of in-hospital mortality than patients without any comorbidity. Conclusion The present results suggested the protective effects of uncomplicated diabetes on short-term surgical outcomes in stage I/II colon cancer patients after open colectomy. Further studies are warranted to confirm these unexpected findings and investigate the possible underlying mechanisms.

Highlights

Colon cancer is the third most commonly diagnosed cancers in the United States (US) and the fourth leading cause of cancer-related death worldwide; colon cancer is associated with a high recurrence rate and poor prognosis [1, 2]
There were no significant differences in the percentages of in-hospital mortality and total postoperative complication rate between colon cancer patients with and without comorbid diabetes
Niemelainen et al [17] previously reported that comorbid diabetes increases the likelihood of postoperative complications in older patients with stage I-III colon cancer undergoing open or laparoscopic surgery [17], the present analysis of the National Inpatient Sample (NIS) (2005-2010) unexpectedly revealed that comorbid diabetes was significantly associated with lower risks of postoperative complications and inhospital mortality in stage I/II colon cancer patients undergoing open colectomy

Summary

Introduction

Colon cancer is the third most commonly diagnosed cancers in the United States (US) and the fourth leading cause of cancer-related death worldwide; colon cancer is associated with a high recurrence rate and poor prognosis [1, 2]. According to a European multicenter randomized trial, patients undergoing open colectomy for stage I-III colon cancer had a mean hospital length of stay (LOS) of 9:3 ± 7:3 days and a postoperative complication rate of 20% in [4]. A Japanese randomized controlled trial found that for the periods of 2004-2005, 2006-2007, and 20082009, the mean lengths of hospital stay were 12, 11, and 11 days, respectively, and postoperative complication rates were 27.6%, 20.3%, and 21.3%, respective, in patients with stage II/III colon cancer after open surgery [5]. A population-based study focusing on stage I-III colon cancer revealed that comorbid diabetes is associated with elevated risk of postoperative complications in patients 80 and older after either open resection or laparoscopic resection in Finland [17]

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