Gastric cancer: comorbid DM tied to higher mortality risk

  • Zheng J & al.
  • Br J Surg
  • 27 Jul 2018

  • curated by Kelli Whitlock Burton
  • Univadis Clinical Summaries
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Takeaway

  • Patients with gastric adenocarcinoma have an increased risk for cancer-specific mortality if they also have diabetes mellitus (DM), especially if they have no other comorbidities or underwent gastrectomy.

Why this matters

  • It was unknown whether the increased mortality risk in patients with gastric cancer plus diabetes was because of diabetes-related comorbidities, or a potential effect of diabetes on gastric adenocarcinoma.

Study design

  • 23,591 patients with gastric adenocarcinoma.
  • Funding: Swedish Research Council and others.

Key results

  • 11.9% of patients had diabetes.
  • Adjusted HR for cancer-specific mortality was higher in patients with diabetes than in those without diabetes (HR, 1.17; 95% CI, 1.11-1.22) and remained higher after adjusting for comorbidity (HR, 1.09; 95% CI, 1.04-1.15).
  • Increased cancer-specific mortality risk was higher in patients without other comorbidities (HR, 1.23; 95% CI, 1.15-1.32), but not in those with other comorbidities, and in those with a history of gastrectomy (HR, 1.27; 95% CI, 1.16-1.38) compared with those who did not (HR, 1.04; 95% CI, 0.98-1.10).
  • Rates among patients with noncardia gastric cancer were similar to overall gastric cancer group.
  • HR for mortality within 12 months of surgery was 1.23 (95% CI, 1.10-1.38) for the diabetes group compared with those without diabetes.

Limitations

  • Retrospective study with all-Swedish cohort.

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