5 april 2011: Bron: Diabetes Care. 2010 Apr;33(4):931-9

Kankerpatienten die ook diabetes 2 hebben lopen een sterk vergroot risico op overlijden na een operatie. Het verschil met mensen die geen diabetes hebben bedraagt maar liefst 50%. Dit blijkt uit een meta analyse van beschikbare studies op dit gebied. Vooral patienten met slokdarmkanker en darmkanker die ook diabetes 2 hebben overlijden relatief vaak vrij kort na een operatie van tumoren. Vooral hartfalen is vaak de oorzaak. Klik hier het volledige studieverslag van deze meta analyse. Hier het abstract van de studie.

Postoperative mortality in cancer patients with preexisting diabetes: systematic review and meta-analysis

Diabetes Care. 2010 Apr;33(4):931-9.

Postoperative mortality in cancer patients with preexisting diabetes: systematic review and meta-analysis.

Barone BB, Yeh HC, Snyder CF, Peairs KS, Stein KB, Derr RL, Wolff AC, Brancati FL.

Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland, USA.


OBJECTIVE: Diabetes appears to increase risk for some cancers, but the association between preexisting diabetes and postoperative mortality in cancer patients is less clear. Our objective was to systematically review postoperative mortality in cancer patients with and without preexisting diabetes and summarize results using meta-analysis. RSEARCH DESIGN AND METHODS: We searched the Medical Literature Analysis and Retrieval System Online (MEDLINE) and Excerpta Medica Database (EMBASE) for articles published on or before 1 July 2009, including references of qualifying articles. We included English language investigations of short-term postoperative mortality after initial cancer treatment. Titles, abstracts, and articles were reviewed by at least two independent readers. Study population and design, results, and quality components were abstracted with standard protocols by one reviewer and checked for accuracy by additional reviewers.

RESULTS: Of 8,828 titles identified in our original search, 20 articles met inclusion criteria for qualitative systematic review. Of these, 15 reported sufficient information to be combined in meta-analysis. Preexisting diabetes was associated with increased odds of postoperative mortality across all cancer types (OR = 1.85 [95% CI 1.40-2.45]). The risk associated with preexisting diabetes was attenuated but remained significant when we restricted the meta-analysis to models that controlled for confounders (1.51 [1.13-2.02]) or when we accounted for publication bias using the trim and fill method (1.52 [1.13-2.04]).

CONCLUSIONS: Compared with their nondiabetic counterparts, cancer patients with preexisting diabetes are approximately 50% more likely to die after surgery. Future research should investigate physiologic pathways to mortality risk and determine whether improvements in perioperative diabetes care can reduce postoperative mortality.

PMID: 20351229 [PubMed - indexed for MEDLINE]PMCID: PMC2845055

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