The impact of diabetes mellitus on clinical outcomes following chemotherapy for the patients with pancreatic cancer: a meta-analysis.

Abstract

A meta-analysis was performed to evaluate the prognostic impact of diabetes on the clinical outcome for patients with pancreatic cancer following the adjuvant chemotherapy. To identify all researches and studies relevant to the prognostic impact of diabetes on the clinical outcome for patients with pancreatic cancer following the adjuvant chemotherapy, a comprehensive literature search was performed until January 30, 2018, by searching PubMed, EMBASE, and the Cochrane Library. The relevant data were extracted from included studies by two reviewers independently. HR and its 95% confidence interval (CI) were synthesized using STATA 12.0 software. All of six studies consisting of 4241 pancreatic cancer patients (1034 patients with DM and 3207 patients without DM) were eligible and included in this meta-analysis. The result of meta-analysis under a fixed model showed that there are significant differences in overall survival (HR 1.16, 95% CI 1.08-1.25, P = 0.000) and T stage (OR 1.30, 95% CI 1.08-2.17, P = 0.005) between PC patients with DM following chemotherapy and PC patients without DM following chemotherapy. There was no significant difference in gender (OR 1.23, 95% CI 1.00-1.50, P = 0.051), tumor locations (OR 1.13, 95% CI 0.81-1.56, P = 0.476), cancer extent (OR 0.85, 95% CI 0.48-1.50, P = 0.569), N stage (OR 1.01, 95% CI 0.58-1.74, P = 0.973), and M stage (OR 0.64, 95% CI 0.21-1.99, P = 0.441) between diabetic PC patients and non-diabetic patients. Diabetes mellitus patients who undergo chemotherapy for pancreatic cancer present with a reduced survival and lager tumor. Pancreatic cancer patients with DM also have a higher risk of death after chemotherapy.