The role of diabetes and other co-morbidities on survival after esophageal cancer surgery in a population-based study

Am J Surg. 2013 Oct;206(4):539-43. doi: 10.1016/j.amjsurg.2013.01.035. Epub 2013 Jun 25.

Abstract

Background: There is limited knowledge on how diabetes and other comorbidities influence the survival of patients undergoing curative esophageal cancer surgery.

Methods: A population-based and prospective cohort study included patients who underwent surgical resection for esophageal or cardia cancer in Sweden from 2001 to 2005, with follow-up until 2011. Associations between diabetes and other comorbidities in relation to postoperative mortality were analyzed using Cox proportional-hazards regression with adjustment for potential confounding factors.

Results: Among 609 patients, 67 (11%) with diabetes had no increased risk for mortality compared with those without diabetes (hazard ratio, .81; 95% confidence interval, .60 to 1.09). Compared with patients without any predefined comorbidities, those with 1 (hazard ratio, 1.15; 95% confidence interval, .93 to 1.43) or ≥2 comorbidities (hazard ratio, 1.05; 95% confidence interval, .83 to 1.33) had no statistically significantly increased risk for mortality.

Conclusions: This study revealed no strongly increased risk for mortality in patients with diabetes or other comorbidities selected for esophageal cancer surgery.

Keywords: Cardia; Esophageal resection; Esophagectomy; Postoperative; Prospective.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / mortality
  • Adenocarcinoma / surgery
  • Aged
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / surgery
  • Cardiovascular Diseases / epidemiology
  • Comorbidity
  • Diabetes Mellitus / epidemiology*
  • Esophageal Neoplasms / mortality*
  • Esophageal Neoplasms / surgery*
  • Esophagectomy
  • Female
  • Follow-Up Studies
  • Gastrectomy
  • Humans
  • Hypertension / epidemiology
  • Kaplan-Meier Estimate
  • Liver Diseases / epidemiology
  • Lung Diseases / epidemiology
  • Male
  • Middle Aged
  • Prognosis
  • Proportional Hazards Models
  • Prospective Studies
  • Renal Insufficiency / epidemiology
  • Sweden / epidemiology