Diabetes Alone should not be a Reason for Withholding Adjuvant Chemotherapy for Stage III Colon Cancer
Document Type
Article
Publication Date
2011
Keywords
colon cancer, comorbidity, diabetes mellitus, population-based, survival, treatment
Digital Object Identifier (DOI)
https://doi.org/10.15256/joc.2011.1.7
Abstract
Background: With increasing prevalence of diabetes mellitus and colon cancer, the number of patients suffering from both diseases is growing, and physicians are being faced with complicated treatment decisions. Objective: To investigate the association between diabetes and treatment/course of stage III colon cancer and the association between colon cancer and course of diabetes. Materials and Methods: Additional information was collected from the medical records of all patients with both stage III colon cancer and diabetes (n=201) and a random sample of stage III colon cancer patients without diabetes (n=206) in the area of the population-based Eindhoven Cancer Registry (1998–2007). Results: Colon cancer patients without diabetes were more likely to receive adjuvant chemotherapy compared with diabetic colon cancer patients (OR 1.8; 95% CI 1.2–2.7). After adjustment for age, this difference was borderline significant (OR 1.6; 95% CI 1.0–2.6). Diabetic patients did not have: significantly more side-effects from surgery or adjuvant chemotherapy; more recurrence from colon cancer; significantly shorter time interval until recurrence; or a poorer disease-free survival or overall survival. Age and withholding of adjuvant chemotherapy were most predictive of all-cause mortality. After colon cancer diagnosis, the dose of antiglycaemic medications was increased in 22% of diabetic patients, resulting in significantly lower glycaemic indexes than before colon cancer diagnosis. Conclusions: Since diabetic patients did not have more side-effects of adjuvant chemotherapy, and adjuvant chemotherapy had a positive effect on survival for both patients with and without diabetes, diabetes alone should not be a reason for withholding adjuvant chemotherapy.
Was this content written or created while at USF?
Yes
Citation / Publisher Attribution
Journal of Comorbidity, v. 1, issue 1, p. 19-27
Scholar Commons Citation
Waalwijk, Maren A.; Schans, Saskia A.; Haak, Harm R.; Extermann, Martine; Dercksen, Wouter M.; and Janssen-Heijnen, Dr Maryska, "Diabetes Alone should not be a Reason for Withholding Adjuvant Chemotherapy for Stage III Colon Cancer" (2011). Internal Medicine Faculty Publications. 252.
https://digitalcommons.usf.edu/intmed_facpub/252
