Abstract:
Objective Pancreatic ductal adenocarcinoma (PDAC) is one of the most aggressive and lethal human cancers. Current studies on the relationship between complicated type 2 diabetes mellitus (T2DM) and PDAC prognosis have demonstrated inconsistent results. The present study aimed to determine the relationship between complicated T2DM and the clinicopathological characteristics of PDAC, and evaluate whether complicated T2DM is a significant predictor for overall survival in patients with resectable PDAC
Methods In this study, clinicopathological characteristics were observed in 136 patients who underwent surgery for PDAC at the Shengjing Hospital of China Medical University between January 2009 and February 2011. The relationship between complicated T2DM and overall survival of PDAC patients was analyzed using univariate and multivariate analyses.
Results The median age of patients was 60 years (range: 35-80 years). Among the 136 patients, 76(55.9%) were male. The prevalence of complicated T2DM was 27.9% in 136 PDAC cases. Preexisting T2DM was not associated with any of the clinicopathological characteristics (all P>0.05). Univariate analysis showed that complicated T2DM (P=0.045), maximum diameter (P=0.011), histological differentiation (P=0.013), pT stage (P=0.034), vessel invasion (P=0.032), and pTNM stage (P=0.030) were significantly associated with the overall survival of PDAC patients. The median overall survival time was 14.2 months for T2DM patients, and 18.8 months for non-T2DM patients. In multivariate analysis, complicated T2DM hazard ratio (HR), 1.873; 95% confidence interval (CI), 1.187-2.954; P=0.007, poorly differentiated tumor (HR, 2.647; 95% CI, 1.413-4.957; P=0.002), and maximum diameter ≥4.0 cm (HR, 1.699; 95% CI, 1.094-2.640; P=0.018) were the independent predictors associated with poor overall survival.
Conclusion Complicated T2DM was associated with poor prognosis. It could be used as a prognostic predictor in patients with resectable PDAC. If confirmed, these findings may provide a novel approach for individualized adjuvant therapy.