Endocrine Abstracts (2011) 26 P732

Relationship between diabetes and pancreatic cancer

M Alves, M Bastos, J Santos, A Vieira, S Gouveia, J Saraiva & M Carvalheiro

Serviço de Endocrinologia, Diabetes e Metabolismo, Hospitais da Universidade de Coimbra, EPE, Coimbra, Portugal.

Background: Pancreatic cancer (PC) is rare, representing 6.8% of mortality in our country. Diabetes mellitus (DM) is often associated. Main hypothesis include: PC triggers DM; DM is a risk factor for PC; diabetes treatment modifies cancer risk.

Objective: To evaluate DM and PC association.

Methods: Evaluation of patients with PC (2006–2009), divided into: group A (without DM) and group B (with DM). Parameters evaluated: age, gender, BMI, hypertension, dyslipidaemia, hyperuricaemia, smoking, alcoholism and pancreatitis; location, tumor size and invasion at diagnosis; treatment and survival. Group B was subdivided according to DM treatment and duration (subgroup B1 ≤1 year, subgroup B2 >1 year).

Results: A total of 132 patients evaluated with PC: 70 male (53%), 62 female (47%). Group A: 59.8% (n=79); at diagnosis: 67.8±14.6 years old, BMI 25.2±3.9 kg/m2, hypertension 38.0%, dyslipidaemia 17.7%, hyperuricemia 2.5%, alcoholism 80.8%, tumor size 4.1 cm. Group B: 40.2% (n=53); at diagnosis: 66.7±12.2 years old, BMI 26.0±4.7 kg/m2, hypertension 69.8%, dyslipidaemia 50.9%, hyperuricemia 17.0%, alcoholism 53.8%, tumor size 3.4 cm. There was statistical difference for: hypertension (OR=3.78), dyslipidaemia (OR=4.82), hyperuricemia (OR=7.86), alcoholism (OR=3.60) and tumor size. There was no statistical difference (P>0.05) for smoking, pancreatitis, tumor location, invasion and mortality. Diabetes treatment in group B: 58.5% on oral agents, 56.6% on insulin. Subgroup B1: 72.0%; subgroup B2: 28.0%. Diabetes duration didn’t influence tumor invasion, but influenced tumor size (subgroups B1 4.55 cm; B2 2.99 cm, P=0.01). Overall survival was 15.3±1.9 months. There was no survival difference between: groups A and B (18.5 vs 11.7 months), treatment with insulin or oral agents (16.9 vs 13.5 months), subgroups B1 and B2 (15.4 vs 15.8 months).

Conclusions: Diabetes may be a consequence of pancreatic cancer since most patients had diabetes for <1 year. There was no difference in survival between groups, irrespective of hypoglycemic therapy. Relationship between DM and PC is complex and needs further investigation.

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