The Effect of Type 2 Diabetes Mellitus on the Short-Term Outcomes and Prognosis of Stage I–III Colorectal Cancer: A Propensity Score Matching Analysis

Figures & data

Figure 1 Flow chart of patient selection.

Table 1 Baseline Characteristics Before and After PSM

Characteristics	Before PSM			After PSM
	T2DM (521)	Non-T2DM (3729)	P value	T2DM (519)	Non-T2DM (519)	P value
Age (years)	68.2 ± 9.7	62.2 ± 12.3	0.000*	68.2 ± 9.7	67.9 ± 11.1	0.662
Sex			0.448			0.572
Male	298 (57.2%)	2198 (58.9%)		296 (57.0%)	305 (58.8%)
Female	223 (42.8%)	1531 (41.1%)		223 (43.0%)	214 (41.2%)
BMI (kg/m^2)	23.6 ± 3.3	22.6 ± 3.2	0.000*	23.5 ± 3.3	23.4 ± 3.3	0.485
Smoking	181 (34.7%)	1426 (38.2%)	0.123	180 (34.7%)	181 (34.9%)	0.948
Drinking	151 (29.0%)	1150 (30.8%)	0.398	150 (28.9%)	148 (28.5%)	0.891
Family history	18 (3.5%)	109 (2.9%)	0.504	18 (3.5%)	17 (3.3%)	0.863
Hypertension	296 (56.8%)	812 (21.8%)	0.000*	294 (56.6%)	309 (59.5%)	0.345
CHD	56 (10.7%)	123 (3.3%)	0.000*	54 (10.4%)	52 (10.0%)	0.838
Tumor location			0.325			0.495
Colon	251 (48.2%)	1711 (45.9%)		250 (48.2%)	261 (50.3%)
Rectum	270 (51.8%)	2018 (54.1%)		269 (51.8%)	258 (49.7%)
Adjuvant therapy	41 (7.9%)	192 (5.1%)	0.011*	40 (7.7%)	32 (6.2%)	0.499
Tumor stage			0.482			0.894
I	96 (18.4%)	754 (20.2%)		96 (18.5%)	102 (19.7%)
II	222 (42.6%)	1610 (43.2%)		220 (42.4%)	217 (41.8%)
III	203 (39.0%)	1365 (36.6%)		203 (39.1%)	200 (38.5%)

Notes: Variables are expressed as the mean ± SD, n (%), *P-value <0.05.

Abbreviations: T2DM, type 2 diabetes mellitus; BMI, body mass index; PSM, propensity score matching; CHD, coronary heart disease; PSM, propensity score matching.

Table 2 Short-Term Outcomes Before and After PSM

Characteristics	Before PSM			After PSM
	T2DM (521)	Non-T2DM (3729)	P value	T2DM (519)	Non-T2DM (519)	P value
Operation time (min)	225.1 ± 77.5	222.4 ± 76.1	0.463	224.6 ± 77.3	227.0 ± 82.1	0.640
Blood loss (mL)	97.4 ± 107.6	100.8 ± 128.0	0.560	95.6 ± 103.0	104.7 ± 143.1	0.240
Retrieved lymph nodes	14.6 ± 9.3	14.7 ± 7.2	0.793	14.7 ± 9.3	14.2 ± 7.0	0.389
Hospital stay (days)	12.5 ± 11.2	11.2 ± 8.4	0.002*	12.5 ± 11.2	11.6 ± 7.7	0.139
Overall complications	149 (28.6%)	778 (20.9%)	0.000*	148 (28.5%)	118 (22.7%)	0.033*
Major complications	17 (3.3%)	82 (2.2%)	0.132	17 (3.3%)	10 (1.9%)	0.172
Postoperative 30-day death	3 (0.6%)	9 (0.2%)	0.174	3 (0.6%)	0 (0.0%)	0.249
Re-operation	12 (2.3%)	59 (1.6%)	0.229	12 (2.3%)	10 (1.9%)	0.666
Anastomotic leakage	20 (3.8%)	82 (2.2%)	0.022*	20 (3.8%)	10 (1.9%)	0.064

Notes: Variables are expressed as the mean ± SD, n (%), *P-value <0.05.

Abbreviations: T2DM, type 2 diabetes mellitus; PSM, propensity score matching.

Table 3 Univariate and Multivariate Analyses of Overall Survival (After PSM)

Risk Factors	Univariate Analysis		Multivariate Analysis
	HR (95% CI)	P value	HR (95% CI)	P value
Age (>/≤69 years)	2.007 (1.486–2.710)	0.000*	1.843 (1.350–2.515)	0.000*
Sex (male/female)	0.891 (0.660–1.202)	0.449
BMI (>/≤23.4 kg/m^2)	0.658 (0.484–0.895)	0.008*	0.706 (0.516–0.965)	0.029*
Hypertension (yes/no)	1.032 (0.767–1.390)	0.834
T2DM (yes/no)	0.956 (0.712–1.283)	0.764
Tumor site (colon/rectum)	1.193 (0.889–1.601)	0.240
Tumor stage (III/II/I)	1.556 (1.253–1.931)	0.000*	1.587 (1.273–1.979)	0.000*
Smoking (yes/no)	0.884 (0.646–1.208)	0.438
Drinking (yes/no)	0.775 (0.551–1.089)	0.142
Family history (yes/no)	0.863 (0.382–1.948)	0.723
CHD (yes/no)	1.086 (0.658–1.791)	0.747
Adjuvant therapy (yes/no)	0.799 (0.354–1.806)	0.590
Overall complications (yes/no)	1.898 (1.407–2.561)	0.000*	1.496 (1.077–2.077)	0.016*
Major complications (yes/no)	2.940 (1.635–5.287)	0.000*	2.767 (1.270–6.029)	0.010*
Anastomotic leakage (yes/no)	2.542 (1.298–4.979)	0.007*	1.225 (0.513–2.929)	0.648

Note: *P-value <0.05.

Abbreviations: HR, hazard ratio; CI, confidence interval; BMI, body mass index; T2DM, type 2 diabetes mellitus; CHD, coronary heart disease; PSM, propensity score matching.

Table 4 Univariate and Multivariate Analyses of Disease-Free Survival (After PSM)

Risk Factors	Univariate Analysis		Multivariate Analysis
	HR (95% CI)	P value	HR (95% CI)	P value
Age (>/≤69 years)	1.747 (1.325–2.303)	0.000*	1.656 (1.245–2.204)	0.001*
Sex (male/female)	0.894 (0.676–1.181)	0.430
BMI (>/≤23.4 kg/m^2)	0.714 (0.538–0.947)	0.019*	0.754 (0.566–1.004)	0.053
Hypertension (yes/no)	1.039 (0.788–1.370)	0.786
T2DM (yes/no)	0.878 (0.667–1.155)	0.353
Tumor site (colon/ rectum)	1.094 (0.833–1.438)	0.518
Tumor stage (III/II/I)	1.796 (1.447–2.229)	0.000*	1.541 (1.258–1.888)	0.000*
Smoking (yes/no)	0.836 (0.623–1.121)	0.230
Drinking (yes/no)	0.777 (0.566–1.066)	0.118
Family history (yes/no)	0.737 (0.327–1.660)	0.461
CHD (yes/no)	1.011 (0.631–1.622)	0.962
Adjuvant therapy (yes/no)	0.996 (0.510–1.945)	0.991
Overall complications (yes/no)	1.622 (1.221–2.155)	0.001*	1.325 (0.971–1.809)	0.076
Major complications (yes/no)	2.506 (1.398–4.494)	0.002*	2.551 (1.198–5.431)	0.015*
Anastomotic leakage (yes/no)	2.154 (1.103–4.208)	0.025*	1.217 (0.522–2.837)	0.649

Note: *P-value <0.05.

Abbreviations: HR, hazard ratio; CI, confidence interval; BMI, body mass index; T2DM, type 2 diabetes mellitus; CHD, coronary heart disease; PSM, propensity score matching.

Figure 2 OS before PSM. (A) All stages; (B) Stage I; (C) Stage II; (D) Stage III.

Abbreviations: OS, overall survival; T2DM, type 2 diabetes mellitus; PSM, propensity score matching.

Figure 3 DFS before PSM. (A) All stages; (B) Stage I; (C) Stage II; (D) Stage III.

Abbreviations: DFS, disease-free survival; T2DM, type 2 diabetes mellitus; PSM, propensity score matching.

Figure 4 OS after PSM. (A) All stages; (B) Stage I; (C) Stage II; (D) Stage III.

Abbreviations: OS, overall survival; T2DM, type 2 diabetes mellitus; PSM, propensity score matching.

Figure 5 DFS after PSM. (A) All stages; (B) Stage I; (C) Stage II; (D) Stage III.

Abbreviations: DFS, disease-free survival; T2DM, type 2 diabetes mellitus; PSM, propensity score matching.