Impact of pre-existing type-2 diabetes on patient outcomes after radical resection for gastric cancer: A retrospective cohort study

Zhe Wei Wei, Jia Ling Li, Ying Wu, Guang Kai Xia, Roderich E. Schwarz, Yu Long He, Chang Hua Zhang

Research output: Contribution to journalArticle

12 Scopus citations

Abstract

Background: The aim of this study was to evaluate the impact of pre-existing type-2 diabetes on postoperative recovery and prognosis in gastric cancer (GC) patients who underwent radical gastrectomy. Research Design and Methods: From June 2001 to June 2011, a total of 1,014 eligible patients were enrolled. Among them, 67 patients were diagnosed with type-2 diabetes. The clinicopathologic features and prognostic data were compared between patients with type-2 diabetes (the DM group) and without diabetes (the non-DM group). Results: Median survival was 68.3 months. The 5-year overall survival in the DM group was similar to that in the non-DM group (52.1 vs. 53.0 %, p = 0.411). Propensity score matching analysis demonstrated that the hazard ratio of death in the DM group was 1.191 (95 % confidential index 0.693-2.072; p = 0.531) compared to the-non DM group. Incidence of postoperative complications was higher in the DM group than in the non-DM group (17.9 vs. 8.1 %, p = 0.006). The DM remission rate was 46 % among patients who received Roux-en-Y reconstruction, and 13 % among patients who received Billroth II anastomosis (p = 0.009). The 5-year overall survival rate was 62.1 % for patients with cured or improved DM and 23.4 % for patients with worse or same DM status (p = 0.003). Conclusion: Type-2 diabetes can be cured by radical gastrectomy plus Roux-en-Y reconstruction in some GC patients. Pre-existing diabetes is associated with increased postoperative complications and decreased survival when it becomes worse after curative dissection for GC.

Original languageEnglish (US)
Pages (from-to)1017-1024
Number of pages8
JournalDigestive Diseases and Sciences
Volume59
Issue number5
DOIs
StatePublished - May 2014

Keywords

  • Complication
  • Gastrectomy
  • Gastric cancer
  • Prognosis
  • Type-2 diabetes mellitus

ASJC Scopus subject areas

  • Physiology
  • Gastroenterology

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