Determining Survival Among OAs With Diabetes, Pancreatic Cancer

According to recent study findings, published online in Endocrine Practice, diabetes mellitus (DM) was not a prognostic factor for overall survival in older adults with pancreatic cancer.  

“DM is a risk factor for pancreatic cancer but its prognostic impact remains controversial,” wrote the authors of the study. “We aimed to investigate the association between long-standing DM and the risk of mortality.”  

In order to understand the association, study authors conducted a population-based cohort study. The researchers analyzed data from a national health care data base in Taiwan, and identified patients diagnosed with pancreatic cancer and excluded those who were diagnosed with DM within 2 years of the cancer diagnosis. 

Using a Cox proportional hazard model, the researchers compared overall survival for the eligible study participants. The participants were grouped into long-standing DM (>2 years) and non-diabetic controls. Finally, the researchers used sensitivity tests that were stratified by cancer stages.  

According to the findings of the study, compared with non-DM controls, patients with long-standing DM were significantly older (mean age, 71.38 vs. 66.0 years, P < 0.0001) and had:

• a higher Charlson comorbidity index (9.53 vs. 6.78, P < 0.0001); and
• diabetes comorbidity severity index (2.38 vs. 0.82, P < 0.0001).

“Although the unadjusted analysis showed a higher risk of mortality in the patients with long-term DM (crude hazard ratio [HR], 1.26; 95% confidence interval [CI], 1.20-1.33, P < 0.0001), the association became insignificant after adjustment for age, sex, and comorbidity index (adjusted HR, 1.01; 95% CI, 0.95-1.06, P = 0.84),” they explained.  

The researchers noted that there was no association between long-term DM and mortality in various subgroups stratified by cancer treatment, according to the subgroup analyses.  

“After adjusting for associated comorbidities and complications, long-standing DM per se was not an independent prognostic factor for overall survival in this nationwide population-based cohort with pancreatic cancer,” study authors concluded.

—Julie Gould

Reference:

Tseng CM, Wang HH, Wang WL, et al. PROGNOSTIC IMPACT OF DIABETES MELLITUS ON OVERALL SURVIVAL IN A NATIONWIDE POPULATION-BASED COHORT OF PATIENTS WITH PANCREATIC CANCER [published online ahead of print, 2020 Mar 11]. Endocr Pract. 2020;10.4158/EP-2019-0565. doi:10.4158/EP-2019-0565