The impact of diabetes mellitus on survival following resection and adjuvant chemotherapy for pancreatic cancer


Kleeff, Jorg, Costello, Eithne, Jackson, Richard, Halloran, Chris ORCID: 0000-0002-5471-4178, Greenhalf, William, Ghaneh, Paula, Lamb, Richard F, Lerch, Markus M, Mayerle, Julia, Palmer, Daniel ORCID: 0000-0002-7147-5703 et al (show 5 more authors) (2016) The impact of diabetes mellitus on survival following resection and adjuvant chemotherapy for pancreatic cancer. BRITISH JOURNAL OF CANCER, 115 (7). pp. 887-894.

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Abstract

<h4>Background</h4>Diabetes mellitus is frequently observed in pancreatic cancer patients and is both a risk factor and an early manifestation of the disease.<h4>Methods</h4>We analysed the prognostic impact of diabetes on the outcome of pancreatic cancer following resection and adjuvant chemotherapy using individual patient data from three European Study Group for Pancreatic Cancer randomised controlled trials. Analyses were carried out to assess the association between clinical characteristics and the presence of preoperative diabetes, as well as the effect of diabetic status on overall survival.<h4>Results</h4>In total, 1105 patients were included in the analysis, of whom 257 (23%) had confirmed diabetes and 848 (77%) did not. Median (95% confidence interval (CI)) unadjusted overall survival in non-diabetic patients was 22.3 (20.8-24.1) months compared with 18.8 (16.9-22.1) months for diabetic patients (P=0.24). Diabetic patients were older, had increased weight and more co-morbidities. Following adjustment, multivariable analysis demonstrated that diabetic patients had an increased risk of death (hazard ratio: 1.19 (95% CI 1.01, 1.40), P=0.034). Maximum tumour size of diabetic patients was larger at randomisation (33.6 vs 29.7 mm, P=0.026).<h4>Conclusions</h4>Diabetes mellitus was associated with increased tumour size and reduced survival following pancreatic cancer resection and adjuvant chemotherapy.

Item Type: Article
Uncontrolled Keywords: pancreatic cancer, diabetes mellitus, prognosis, resection, adjuvant therapy
Depositing User: Symplectic Admin
Date Deposited: 05 Sep 2016 13:53
Last Modified: 19 Jan 2023 07:30
DOI: 10.1038/bjc.2016.277
Related URLs:
URI: https://livrepository.liverpool.ac.uk/id/eprint/3003163
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