Colorectal cancer outcomes, recurrence, and complications in persons with and without diabetes mellitus: A systematic review and meta-analysis

Kelly B. Stein, Claire F. Snyder, Bethany B. Barone, Hsin Chieh Yeh, Kimberly S. Peairs, Rachel L. Derr, Antonio C. Wolff, Frederick L. Brancati

Research output: Contribution to journalReview articlepeer-review

Abstract

Background: Diabetes mellitus increases the risk of incident colorectal cancer, but it is less clear if pre-existing diabetes mellitus influences mortality outcomes, recurrence risk, and/or treatment-related complications in persons with colorectal cancer. Methods: We performed a systematic review and meta-analysis comparing colorectal cancer mortality outcomes, cancer recurrence, and treatment-related complications in persons with and without diabetes mellitus. We searched MEDLINE and EMBASE through October 1, 2008, including hand-searching references of qualifying articles. We included studies in English that evaluated diabetes mellitus and cancer treatment outcomes, prognosis, and/or mortality. The initial search identified 8,208 titles, of which 15 articles met inclusion criteria. Each article was abstracted by one author using a standardized form and re-reviewed by another author for accuracy. Authors graded quality based on pre-determined criteria. Results: We found significantly increased short-term perioperative mortality in persons with diabetes mellitus. In the meta-analysis of long-term mortality, persons with diabetes mellitus had a 32% increase in all-cause mortality compared to those without diabetes mellitus (95% CI: 1.24, 1.41). Although data on other outcomes are limited, available studies suggest that pre-existing diabetes mellitus predicts increased risk of some post-operative complications as well as 5-year cancer recurrence. In contrast, there is little evidence that diabetes confers increased risk for long-term cancer-specific mortality. Conclusions: Patients with colorectal cancer and pre-existing diabetes mellitus have an increased risk of short- and long-term mortality. Future research should determine whether improvements in prevention and treatment of diabetes mellitus will improve outcomes for colorectal cancer patients.

Original languageEnglish (US)
Pages (from-to)1839-1851
Number of pages13
JournalDigestive diseases and sciences
Volume55
Issue number7
DOIs
StatePublished - Jul 2010

Keywords

  • Colorectal carcinoma
  • Diabetes mellitus
  • Fatal outcome
  • Mortality
  • Treatment outcome

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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