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

Autor: Kleeff J; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Costello E; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Jackson R; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Halloran C; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Greenhalf W; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Ghaneh P; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Lamb RF; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Lerch MM; Department of Medicine A, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany., Mayerle J; Department of Medicine A, Ernst-Moritz-Arndt-University Greifswald, Greifswald, Germany., Palmer D; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Cox T; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Rawcliffe CL; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK., Strobel O; Department of Surgery, University of Heidelberg, Heidelberg, Germany., Büchler MW; Department of Surgery, University of Heidelberg, Heidelberg, Germany., Neoptolemos JP; Liverpool Cancer Research UK Cancer Trials Unit, Liverpool Cancer Research UK Centre, University of Liverpool, Liverpool, UK.; NIHR Pancreas Biomedical Research Unit, University of Liverpool, Liverpool L69 3GA, UK.
Jazyk: angličtina
Zdroj: British journal of cancer [Br J Cancer] 2016 Sep 27; Vol. 115 (7), pp. 887-94. Date of Electronic Publication: 2016 Sep 01.
DOI: 10.1038/bjc.2016.277
Abstrakt: Background: Diabetes mellitus is frequently observed in pancreatic cancer patients and is both a risk factor and an early manifestation of the disease.
Methods: 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.
Results: 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).
Conclusions: Diabetes mellitus was associated with increased tumour size and reduced survival following pancreatic cancer resection and adjuvant chemotherapy.
Databáze: MEDLINE
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