Sun Yat-sen University Cancer Center, State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, 510060, China.
Department of Interventional Oncology, The First Affiliated Hospital, Sun Yat-sen University, No. 58, Zhongshan Second Road, Guangzhou, 510080, Guangdong, P. R. China.
Cancer Commun (Lond). 2018 Apr 27;38(1):14. doi: 10.1186/s40880-018-0275-2.
The association between type 2 diabetes mellitus (T2DM) and the risk of esophageal cancer remains unclear. The present study aimed to evaluate the impact of T2DM on short-term outcomes and long-term survival in patients with esophageal squamous cell cancer (ESCC).
The present retrospective study included 862 patients diagnosed with ESCC between January 2001 and December 2010. Among them, 280 patients had T2DM. A 1:1 propensity score-matched cohort consisting of 280 patients with and 280 without T2DM was selected from the 862 patients. The associations between T2DM and clinicopathologic characteristics were assessed using the χ or Fisher's exact test. Survival of ESCC patients with and without T2DM was calculated by using the Kaplan-Meier method and compared by using the Cox regression model between the two groups.
The occurrence rate of anastomotic leakage was significantly higher in patients with T2DM than in those without T2DM (P < 0.001). In the subgroup with weight loss rate ≤ 5.05%, ESCC patients with T2DM had a significant longer overall survival than did those without T2DM (P = 0.003), whereas in the subgroup with weight loss rate > 5.05%, the patients without T2DM showed a longer survival (P = 0.001). Univariate and multivariate analysis results showed that T2DM was not an independent prognostic factor for patient survival.
Type 2 diabetes mellitus is not an independent prognostic factor in patients with ESCC. However, the combination of T2DM with severe weight loss would be a predictor of poor prognosis.
2 型糖尿病（T2DM）与食管癌风险之间的关系尚不清楚。本研究旨在评估 T2DM 对食管鳞状细胞癌（ESCC）患者短期结局和长期生存的影响。
本回顾性研究纳入了 2001 年 1 月至 2010 年 12 月期间诊断为 ESCC 的 862 例患者。其中，280 例患者患有 T2DM。从 862 例患者中选择了 1：1 倾向评分匹配的队列，包括 280 例患有和 280 例未患有 T2DM 的患者。使用 χ²或 Fisher 确切检验评估 T2DM 与临床病理特征之间的关系。使用 Kaplan-Meier 方法计算 ESCC 患者有和无 T2DM 的生存情况，并通过两组之间的 Cox 回归模型进行比较。
T2DM 患者的吻合口漏发生率明显高于无 T2DM 患者（P<0.001）。在体重减轻率≤5.05%的亚组中，患有 T2DM 的 ESCC 患者的总生存时间明显长于无 T2DM 的患者（P=0.003），而在体重减轻率>5.05%的亚组中，无 T2DM 的患者的生存时间更长（P=0.001）。单因素和多因素分析结果表明，T2DM 不是患者生存的独立预后因素。
T2DM 不是 ESCC 患者的独立预后因素。然而，T2DM 与严重体重减轻相结合可能是预后不良的预测指标。
