The Impact of Diabetes Mellitus on the Second Primary Malignancies in Colorectal Cancer Patients

@article{1763426,
   author = {Halámková, Jana and Kazda, Tomáš and Pehalová, Lucie and Goněc, Roman and Kozakova, Sarka and Bohovicova, Lucia and Slabý, Ondřej and Demlová, Regina and Svoboda, Marek and Kiss, Igor},
   article_location = {Lausanne},
   article_number = {January 2021},
   doi = {http://dx.doi.org/10.3389/fonc.2020.573394},
   keywords = {diabetes mellitus; second primary malignancies; second primary neoplasms; multiple primary neoplasms; colorectal cancer; cancer survivors},
   language = {eng},
   issn = {2234-943X},
   journal = {Frontiers in Oncology},
   title = {The Impact of Diabetes Mellitus on the Second Primary Malignancies in Colorectal Cancer Patients},
   url = {https://www.frontiersin.org/articles/10.3389/fonc.2020.573394/full},
   volume = {10},
   year = {2021}
}

TY  - JOUR
ID  - 1763426
AU  - Halámková, Jana - Kazda, Tomáš - Pehalová, Lucie - Goněc, Roman - Kozakova, Sarka - Bohovicova, Lucia - Slabý, Ondřej - Demlová, Regina - Svoboda, Marek - Kiss, Igor
PY  - 2021
TI  - The Impact of Diabetes Mellitus on the Second Primary Malignancies in Colorectal Cancer Patients
JF  - Frontiers in Oncology
VL  - 10
IS  - January 2021
SP  - 1-10
EP  - 1-10
PB  - Frontiers Media S.A.
SN  - 2234943X
KW  - diabetes mellitus
KW  - second primary malignancies
KW  - second primary neoplasms
KW  - multiple primary neoplasms
KW  - colorectal cancer
KW  - cancer survivors
UR  - https://www.frontiersin.org/articles/10.3389/fonc.2020.573394/full
N2  - Introduction All colorectal cancer (CRC) survivors have an increased risk of developing second primary malignancies (SPMs). The association between diabetes mellitus (DM) and the risk of cancer is well known. However, the role of DM and its therapy in the development of SPMs in CRC patients is not well described. Methods In this single-institutional retrospective analysis we identified 1,174 colorectal carcinoma patients, median follow-up 10.1 years, (median age 63 years, 724 men). All patients over 18 years with histologically confirmed CRC who were admitted in the period 1.1. 2003- 31.12.2013 and followed-up till 31.12. 2018 at the Masaryk Memorial Cancer Institute (MMCI) were screened for eligibility. The exclusion criteria were CRC diagnosed at autopsy, lost to follow-up and high risk of development of SPMs due to hereditary cancer syndrome. Tumours are considered multiple primary malignancies if arising in different sites and/or are of a different histology or morphology group. Comparisons of the basic characteristics between the patients with SPM and the patients without SPM were performed as well as comparison of the occurrence of SPMs by the site of diagnosis between the DM and non-DM cohorts and survival analyses. Results A SPM was diagnosed in 234 (20%) patients, DM in 183 (15%) patients. DM was diagnosed in 22.6% of those with SPM vs. in 13.8% of those without SPM (p=0.001). The most common types of SPMs in DM patients were other CRC, kidney, lung, bladder and nonmelanoma skin cancer, but only carcinoma of the liver and bile duct tracts was significantly more common than in the group without DM. Although breast cancer was the second most common in the group with DM, its incidence was lower than in the group without DM, as well as prostate cancer. A significantly higher incidence of SPMs was found in older CRC patients (>= 65 years) and in those with lower stage colon cancer and DM. No significant difference in DM treatment between those with and without a SPM was observed including analysis of type of insulin. Conclusion CRC patients with diabetes mellitus, especially those with older age, and early stages of colon cancer, should be screened for second primary malignancies more often than the standard population. Patients without DM have longer survival. According to the occurrence of the most common second malignancies, a clinical examination, blood count, and ultrasound of the abdomen is appropriate, together with standard breast and colorectal cancer screening, and lung cancer screening under certain conditions, and should be recommended in CRC survivors especially in patients with intercurrent DM, however the necessary frequency of screening remains unclear.
ER  - 

HALÁMKOVÁ, Jana, Tomáš KAZDA, Lucie PEHALOVÁ, Roman GONĚC, Sarka KOZAKOVA, Lucia BOHOVICOVA, Ondřej SLABÝ, Regina DEMLOVÁ, Marek SVOBODA and Igor KISS. The Impact of Diabetes Mellitus on the Second Primary Malignancies in Colorectal Cancer Patients. Online. \textit{Frontiers in Oncology}. Lausanne: Frontiers Media S.A., 2021, vol.~10, January 2021, p.~1-10. ISSN~2234-943X. Available from: https://dx.doi.org/10.3389/fonc.2020.573394. [citováno 2024-04-23]