Diabetes is associated with increased perioperative mortality but equivalent long-term outcome after hepatic resection for colorectal cancer Journal Article

Authors: Little, S. A.; Jarnagin, W. R.; DeMatteo, R. P.; Blumgart, L. H.; Fong, Y.
Article Title: Diabetes is associated with increased perioperative mortality but equivalent long-term outcome after hepatic resection for colorectal cancer
Abstract: Diabetes is associated with alterations in liver metabolism and immune response that may influence postoperative recovery and long-term survival after hepatectomy for cancer. Patients with type I or type II diabetes mellitus submitted to a potentially curative hepatic resection for metastatic colorectal cancer were identified from the prospective database, and compared with patients with hepatic colorectal metastases submitted to resection during the same time interval, but without diabetes mellitus. Data on operative morbidity and mortality and long-term survival were analyzed. Between December 1990 and July 1999, a total of 727 patients underwent hepatic resection, 61 of whom (8.1%) had type land type II diabetes mellitus. Operative mortality in the diabetic patients was significantly greater than in nondiabetic patients (8% vs. 2%, P < 0.02). Among patients with diabetes mellitus, four of the five perioperative deaths were due to liver failure after major hepatic resection (lobectomy or greater). All four of these patients had significant parenchymal abnormality (three with steatosis). Long-term survival was identical to that in nondiabetic control subjects. We conclude that the presence of diabetes is associated with a higher incidence of perioperative mortality. In patients with diabetes mellitus and parenchymal steatosis, major hepatic resection should be undertaken with caution. © 2002 Society for Surgery of the Alimentary Tract, Inc.
Keywords: survival; adult; cancer chemotherapy; cancer survival; controlled study; treatment outcome; aged; aged, 80 and over; middle aged; survival analysis; major clinical study; case control study; case-control studies; mortality; fluorouracil; gastrointestinal hemorrhage; liver neoplasms; comparative study; chemotherapy; follow up; methodology; follow-up studies; prospective study; prospective studies; colorectal cancer; metastasis; bleeding; heart disease; morbidity; risk factors; pathology; data base; risk factor; risk assessment; postoperative complication; colorectal neoplasms; postoperative complications; cause of death; liver failure; liver metastasis; probability; intraoperative period; colorectal tumor; folinic acid; liver tumor; diabetes mellitus; reference values; bile leakage; urinary tract infection; insulin; liver resection; postoperative infection; sepsis; hepatectomy; colorectal surgery; oral antidiabetic agent; insulin dependent diabetes mellitus; diabetes mellitus, type 1; non insulin dependent diabetes mellitus; liver lobectomy; liver injury; respiratory tract disease; fatty liver; steatosis; reference value; hepatic resection; hepatorenal syndrome; levamisole; peritonitis; hemoperitoneum; humans; human; male; female; article
Journal Title: Journal of Gastrointestinal Surgery
Volume: 6
Issue: 1
ISSN: 1091-255X
Publisher: Springer  
Date Published: 2002-02-01
Start Page: 88
End Page: 94
Language: English
DOI: 10.1016/s1091-255x(01)00019-1
PUBMED: 11986023
PROVIDER: scopus
Notes: Export Date: 14 November 2014 -- Source: Scopus
Altmetric Score
MSK Authors
  1. Sarah Little
    5 Little
  2. Leslie H Blumgart
    347 Blumgart
  3. Ronald P DeMatteo
    610 DeMatteo
  4. William R Jarnagin
    605 Jarnagin
  5. Yuman Fong
    746 Fong