Long-Term Survival in 200 Patients with Advanced Stage of Colorectal Carcinoma and Diabetes Mellitus—A Single Institution Experience

Objective: Colorectal cancer surgery is often followed by postoperative complications which may impact survival. Diabetes mellitus (DM) and DM related comorbidities may initiate difficulties during cancer specific treatment and may have an impact on cancer management and outcome. The aim of our study was to find out if DM in patients with advanced colorectal carcinoma is associated with cancer-specific and overall survival.

Material and Methods: This study included 200 consecutive patients (131 males, 69 females, mean age 63 years) with elective colorectal cancer surgery at the Institute of Oncology Ljubljana from September 2010 to March 2013. Even 64% of patients had Stage 3 or 4 disease, so neo-adjuvant chemotherapy and/or radiotherapy were carried out in 59% of cases. DM was found in 39 (19.5%) patients. Data about gender, age, body mass index, presence of DM, American Society of Anesthesiologists (ASA) physical status score, stage of disease and postoperative complications were collected prospectively. Univariate survival analysis was used to identify factors correlated with disease-specific and overall survival.

Results: Patients with DM had higher ASA score and BMI than those without DM. Rectum, colon and both of them were affected by cancer in 68%, 30% and 2% of cases, respectively. Stage 3 or 4 disease was found in patients with DM and without DM in 62% and 65%, respectively. Mean follow-up period was 4.75 years. Recurrence was diagnosed in 23% of patients with DM and in 25% of patients without DM. Altogether 41 patients died of cancer and 12 patients of other causes. Three-year cancer-specific survival in patients with DM and without DM was 85% and 89%, respectively (p=0.68). Three-year overall survival in patients with DM and without DM was 82% and 84%, respectively (p=0.63).

Conclusions: Presence of DM was not associated with tumor stage, disease-specific survival or overall survival in our group of patients with advanced colorectal carcinoma.