PD09.07. Impact of Type 2 Diabetes on Outcomes of Neoadjuvant Therapy and Surgery for Esophageal Cancer: A Multi-Center Retrospective Study

Abstract

Esophageal Cancer: Surgical Treatment of Esophageal Cancer – early outcomes and complications The prognostic impact of type 2 diabetes in esophageal cancer patients receiving neoadjuvant therapy followed by surgery remains unclear. We evaluated its association with perioperative outcomes and long-term survival. We retrospectively analyzed 1,099 patients who underwent neoadjuvant therapy followed by surgery between 2013 and 2024 across three high-volume centers. Type 2 diabetes was defined according to American Diabetes Association criteria. A 1:4 propensity score matching analysis was performed to minimize baseline imbalance. Perioperative outcomes, overall survival (OS), and progression-free survival (PFS) were compared between diabetic and non-diabetic patients. After matching, 114 diabetic patients were compared with 456 non-diabetic patients. No significant differences were observed in length of hospital stay, re-operation, re-admission, total complications, or specific postoperative morbidities. After a median follow-up of 1,086 days, 2- and 3-year OS rates were 73.9% vs 77.2% and 62.4% vs 67.8%, respectively (HR 0.84, 95% CI 0.57–1.22, P=0.356). After a median follow-up of 927 days, 2- and 3-year PFS rates were 73.2% vs 65.1% and 65.2% vs 62.4%, respectively (HR 1.13, 95% CI 0.78–1.63, P=0.529). Type 2 diabetes was not associated with inferior survival outcomes. Type 2 diabetes was not associated with increased perioperative morbidity or impaired long-term survival following neoadjuvant therapy and surgery.