Year: 2015
Type: letter
Abstract: We appreciate the interest of Mao et al 1 in our article entitled, "Survival Among Patients With Pancreatic Cancer and Long-Standing or Recent-Onset Diabetes Mellitus." 2 In our study, we examined the association of long-standing ( 4 years) and recent-onset diabetes ( 4 years) with survival among patients with pancreatic cancer drawn from two prospective cohort studies We noted a consistent and statistically significant reduction in survival among patients with long-term diabetes in the cohort and clinic-based studies. However, we noted no statistically significant association of recent-onset diabetes with survival in any of the individual studies or in a meta-analysis of the three studies. Mao et al noted that the prevalence of recent-onset diabetes was relatively low in patients enrolled in the prospective cohorts, possibly because of lower ascertainment of diabetes status with the use of biennial questionnaires. We agree that a lower ascertainment of diabetes status near the time of cancer diagnosis is a potential limitation of the cohort study design. Nevertheless, we found no statistically significant heterogeneity (P heterogeneity .63) in the association of recent-onset diabetes with survival among patients from the prospective cohort studies and clinic-based case series with a meta-analysis hazard ratio (HR) of 1.12 (95% CI, 0.90 to 1.39). HRs for death for recent-onset diabetes were similar for clinic-based studies (HR, 1.13; 95% CI, 1.02 to 1.25) and prospective cohort studies (HR, 1.12; 95% CI, 0.95 to 1.32) in the unpublished meta-analyses presented by Mao et al.
Source: Journal of Clinical Oncology
Authors: Chen Yuan, Brian M. Wolpin
Language: English
Subfield: Oncology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2123922679