PMID- 36819384
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230224
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 1
DP  - 2023 Jan
TI  - Prognostic Impact of Type 2 Diabetes in Metastatic Colorectal Cancer.
PG  - e33916
LID - 10.7759/cureus.33916 [doi]
LID - e33916
AB  - Background Diabetes mellitus (DM) is a prognostic factor for some malignancies, 
      but its clinical implications in metastatic colorectal cancer (mCRC) patients are 
      less clear. Therefore, we conducted a retrospective study to evaluate the impact 
      of pre-existing type 2 diabetes mellitus (T2DM) on the survival outcomes of 
      patients with newly diagnosed mCRC. Methodology We retrospectively included 
      patients with newly diagnosed mCRC between January 2017 and June 2021 and with 
      pre-existing T2DM. Data on the characteristics of patients, clinicopathological 
      features, and drug exposure were collected from the electronic medical records. 
      The primary endpoint was overall survival (OS). Secondary endpoints were 
      progression-free survival (PFS) and treatment-related adverse events (TRAEs). 
      Results Among 187 mCRC patients, 54 (28.8%) had T2DM. The median follow-up was 25 
      months. We observed 150 OS events and 168 PFS events. Diabetes significantly and 
      negatively impacted PFS and OS. The median for PFS (mPFS) was eight and 16 months 
      for T2DM and no T2DM patients, respectively (p < 0.0001; log-rank test). The 
      median overall survival (mOS) was 15 and 29 months for T2DM and no T2DM patients, 
      respectively (p < 0.0001; log-rank test). Patients with diabetes were more often 
      overweight or obese (59.3% vs. 24.8%; p < 0.01) and had a poorer performance 
      status (53.7% vs. 21.1% with Eastern Cooperative Oncology Group Performance 
      Status 1; p < 0.01). Additionally, T2DM patients had more high-risk pathological 
      features, including G3 grading tumors (27.7% vs. 12.0%; p = 0.01), lymph node 
      involvement (p < 0.01), BRAF-mutated (35.1% vs. 6.8%; p < 0.01), and right-sided 
      CRC (63.0% vs. 30.1%; p < 0.01). We found no statistically significant 
      differences in TRAEs. Nevertheless, a significantly higher rate of grade 2-4 
      peripheral neuropathy (22.2% vs. 5.3%; p < 0.01) was reported in T2DM patients. 
      Conclusions T2DM is a negative prognostic factor for survival in mCRC. The paper 
      provides empirical evidence in favor of the joint control of both pathologies. 
      Further research is needed to establish the robustness of our results.
CI  - Copyright (c) 2023, Miranda Baleiras et al.
FAU - Miranda Baleiras, Mafalda
AU  - Miranda Baleiras M
AD  - Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisbon, 
      PRT.
FAU - Dias Domingues, Tiago
AU  - Dias Domingues T
AD  - Centre of Statistics and its Applications (CEAUL), Faculdade de Ciencias da 
      Universidade de Lisboa, Lisbon, PRT.
FAU - Severino, Eduardo
AU  - Severino E
AD  - Centre of Statistics and its Applications (CEAUL), Faculdade de Ciencias da 
      Universidade de Lisboa, Lisbon, PRT.
FAU - Vasques, Carolina
AU  - Vasques C
AD  - Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisbon, 
      PRT.
FAU - Neves, Maria Teresa
AU  - Neves MT
AD  - Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisbon, 
      PRT.
FAU - Ferreira, Andre
AU  - Ferreira A
AD  - Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisbon, 
      PRT.
FAU - Vasconcelos de Matos, Leonor
AU  - Vasconcelos de Matos L
AD  - Breast Unit, Centro Clinico Champalimaud, Lisboa, PRT.
FAU - Ferreira, Filipa
AU  - Ferreira F
AD  - Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisbon, 
      PRT.
FAU - Miranda, Helena
AU  - Miranda H
AD  - Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisbon, 
      PRT.
FAU - Martins, Ana
AU  - Martins A
AD  - Department of Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisbon, 
      PRT.
LA  - eng
PT  - Journal Article
DEP - 20230118
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC9936570
OTO - NOTNLM
OT  - diabetes mellitus
OT  - hyperinsulinemia
OT  - insulin resistance
OT  - metastatic colorectal cancer
OT  - metformin
OT  - prognosis
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/02/24 06:00
MHDA- 2023/02/24 06:01
PMCR- 2023/01/18
CRDT- 2023/02/23 10:02
PHST- 2023/01/18 00:00 [accepted]
PHST- 2023/02/23 10:02 [entrez]
PHST- 2023/02/24 06:00 [pubmed]
PHST- 2023/02/24 06:01 [medline]
PHST- 2023/01/18 00:00 [pmc-release]
AID - 10.7759/cureus.33916 [doi]
PST - epublish
SO  - Cureus. 2023 Jan 18;15(1):e33916. doi: 10.7759/cureus.33916. eCollection 2023 
      Jan.