Cancer Medicine (Oct 2020)
Nutritional status and survival of 8247 cancer patients with or without diabetes mellitus—results from a prospective cohort study
- Minghua Cong,
- Wenjie Zhu,
- Chang Wang,
- Zhenming Fu,
- Chunhua Song,
- Zhong Dai,
- Keqing Yao,
- Zengqing Guo,
- Yuan Lin,
- Yingying Shi,
- Wen Hu,
- Yi Ba,
- Suyi Li,
- Zengning Li,
- Kunhua Wang,
- Jing Wu,
- Ying He,
- Jiajun Yang,
- Conghua Xie,
- Xinxia Song,
- Gongyan Chen,
- Wenjun Ma,
- Suxia Luo,
- Zihua Chen,
- Hu Ma,
- Chunling Zhou,
- Wei Wang,
- Qi Luo,
- Yongmei Shi,
- Yumei Qi,
- Haiping Jiang,
- Wenxian Guan,
- Junqiang Chen,
- Jiaxin Chen,
- Yu Fang,
- Lan Zhou,
- Yongdong Feng,
- Rongshao Tan,
- Tao Li,
- Junwen Ou,
- Qingchuan Zhao,
- Jianxiong Wu,
- Li Deng,
- Xin Lin,
- Liuqing Yang,
- Hongxia Xu,
- Wei Li,
- Lei Yu,
- Hanping Shi,
- Investigation on Nutrition Status, Clinical Outcome of Common Cancers (INSCOC) Group
Affiliations
- Minghua Cong
- Department of Comprehensive Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Beijing China
- Wenjie Zhu
- Department of Comprehensive Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Beijing China
- Chang Wang
- Cancer Center of the First Hospital of Jilin University Changchun China
- Zhenming Fu
- Cancer Center Renmin Hospital of Wuhan University Wuhan China
- Chunhua Song
- Department of Epidemiology College of Public Health Zhengzhou University Zhengzhou China
- Zhong Dai
- Department of Comprehensive Oncology Huanxing Cancer Hospital Beijing China
- Keqing Yao
- Department of Comprehensive Oncology Huanxing Cancer Hospital Beijing China
- Zengqing Guo
- Department of Medical Oncology Fujian Cancer HospitalFujian Medical University Cancer Hospital Fuzhou China
- Yuan Lin
- Department of Gastrointestinal Surgery Affiliated Tumor Hospital of Guangxi Medical University Nanning China
- Yingying Shi
- Department of Surgery The First Affiliated Hospital of SunYat‐sen University Guangzhou China
- Wen Hu
- Department of Clinical Nutrition West China Hospital of Sichuan University Chengdu China
- Yi Ba
- Department of Gastrointestinal Oncology Tianjin Key Laboratory of Cancer Prevention and Therapy Tianjin Medical University Cancer Institute and HospitalNational Clinical Research Center for Cancer Tianjin China
- Suyi Li
- Department of Nutrition and Metabolism of Oncology Affiliated Provincial Hospital of Anhui Medical University Hefei China
- Zengning Li
- Department of Clinical Nutrition The First Hospital of Hebei Medical University Shijiazhuang China
- Kunhua Wang
- Department of Gastrointestinal Surgery Institute of Gastroenterology The First Affiliated Hospital of Kunming Medical University Kunming China
- Jing Wu
- Department of Clinical Nutrition The First People's Hospital of Kashi Xinjiang China
- Ying He
- Department of Clinical Nutrition Chongqing General Hospital Chongqing China
- Jiajun Yang
- Department of Colorectal and Anal Surgery Huizhou Municipal Central Hospital Huizhou China
- Conghua Xie
- Department of Radiation and Medical Oncology Zhongnan Hospital of Wuhan University Wuhan China
- Xinxia Song
- Department of Oncology Xingtai People’s HospitalHebei Medical University Xingtai China
- Gongyan Chen
- The First Department of the Tumor Hospital of Harbin Medical University Harbin China
- Wenjun Ma
- Department of Nutrition Guangdong General HospitalGuangdong Academy of Medical Sciences Guangzhou China
- Suxia Luo
- Department of Oncology Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital Zhengzhou China
- Zihua Chen
- Department of General Surgery Xiangya HospitalCentral South University Changsha China
- Hu Ma
- Department of Oncology Affiliated Hospital of Zunyi Medical University Zunyi China
- Chunling Zhou
- The Fourth Affiliated HospitalHarbin Medical University Harbin China
- Wei Wang
- Cancer Center The First People's Hospital of Foshan Foshan China
- Qi Luo
- Department of Gastrointestinal Tumor Surgery The First Affiliated HospitalXiamen University Xiamen China
- Yongmei Shi
- Department of Nutrition Ruijin HospitalShanghai Jiao Tong University School of Medicine Shanghai China
- Yumei Qi
- Department of Nutrition Tianjin Third Central Hospital Tianjin China
- Haiping Jiang
- Department of Surgery The First Affiliated Hospital of Jinan University Guangzhou China
- Wenxian Guan
- Department of General Surgery Nanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical School Nanjing China
- Junqiang Chen
- Department of Gastrointestinal Surgery First Affiliated Hospital of Guangxi Medical University Nanning China
- Jiaxin Chen
- Department of Radiation and Medical Oncology People's Hospital of Guangxi Zhuang Autonomous Region Nanning China
- Yu Fang
- Department of Clinical Nutrition Peking University Cancer Hospital and Institute Beijing China
- Lan Zhou
- Department of Nutrition Third Affiliated Hospital of Kunming Medical CollegeTumor Hospital of Yunnan Province Kunming China
- Yongdong Feng
- Department of Surgery Tongji HospitalTongji Medical CollegeHuazhong University of Science and Technology Wuhan China
- Rongshao Tan
- Department of Nutrition Guangzhou Red Cross Hospital Guangzhou China
- Tao Li
- Department of Radiotherapy Sichuan Cancer Hospital & InstituteSichuan Cancer CenterSchool of MedicineUniversity of Electronic Science and Technology of China Chengdu China
- Junwen Ou
- Department of Clinical Nutrition Clifford HospitalGuangzhou University of Chinese Medicine Guangzhou China
- Qingchuan Zhao
- Department of Digestive Diseases Xijing HospitalFourth Military Medical University Xi'an China
- Jianxiong Wu
- Department of Hepatobiliary Surgery National Cancer Center/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Beijing China
- Li Deng
- Cancer Center of the First Hospital of Jilin University Changchun China
- Xin Lin
- Department of Nutrition Daping Hospital & Research Institute of Surgery Third Military Medical University Chongqing China
- Liuqing Yang
- Department of Gastrointestinal Surgery/Clinical Nutrition Beijing Shijitan HospitalCapital Medical UniversityThe 9th Clinical College Beijing China
- Hongxia Xu
- Department of Nutrition Daping Hospital & Research Institute of Surgery Third Military Medical University Chongqing China
- Wei Li
- Cancer Center of the First Hospital of Jilin University Changchun China
- Lei Yu
- Department of Comprehensive Oncology National Cancer Center/National Clinical Research Center for Cancer/Cancer HospitalChinese Academy of Medical Sciences and Peking Union Medical College Beijing China
- Hanping Shi
- Department of Gastrointestinal Surgery/Clinical Nutrition Beijing Shijitan HospitalCapital Medical UniversityThe 9th Clinical College Beijing China
- Investigation on Nutrition Status, Clinical Outcome of Common Cancers (INSCOC) Group
- DOI
- https://doi.org/10.1002/cam4.3397
- Journal volume & issue
-
Vol. 9,
no. 20
pp. 7428 – 7439
Abstract
Abstract Background The number of cancer patients with diabetes mellitus (DM) is steadily rising. Little is known about the nutritional status of this population. This study characterized the nutritional status and survival of cancer patients with diabetes compared with those without diabetes. Methods A total of 8247 cancer patients were prospectively enrolled from 72 hospitals in China and followed until August 2019. A global estimation of the nutritional status was performed for each participant using standardized tools. The outcomes were cancer‐specific survival (CSS) and overall survival (OS). Results The incidence of diabetes was 7.6% in the whole population. In comparison with the non‐DM group, the DM group had greater body weight, but a similar fat‐free mass, a lower handgrip strength and a decreased Karnofsky performance score. A higher proportion of patients with diabetes were overweight/obese as indicated by BMI. The percentage of patients who were at risk of malnutrition (evaluated by PG‐SGA) was higher in the DM group (score ≥ 4, 56.7% vs 52.9%). Patients with DM showed a worse CSS (4‐year CSS, 62% vs 73%) and OS (4‐year OS 39% vs 52%). Diabetes was associated with an increased risk of both cancer‐specific (hazard ratio (HR) = 1.282, 95% confidence interval (CI) 1.070‐1.536) and overall (HR = 1.206, 95% CI 1.040‐1.399) mortality. Conclusions Cancer patients with diabetes had a larger body mass but lower muscle strength, poorer performance status and higher incidence of malnourishment. Diabetes was associated with compromised survival. Tailored nutritional intervention is necessary for this subpopulation of patients.
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