Pancreatic cancer and coexisting diabetes: Survival outcomes from a provincial Canadian cohort.

674 Background: Diabetes mellitus (DM) is both a risk factor for and a potential consequence of pancreatic ductal adenocarcinoma (PDAC). Its prognostic role remains controversial, with conflicting evidence regarding its effect on survival. We evaluated the impact of DM on outcomes in a large, population-based cohort of patients (pts) with PDAC. Methods: We conducted a retrospective cohort study of patients with biopsy-proven PDAC diagnosed in Saskatchewan between 2016–2021. Kaplan–Meier estimates were compared by log-rank testing. Multivariate Cox proportional hazards regression identified independent predictors of overall survival (OS) and disease-free survival (DFS). Results: Of the 954 pts, 557 were eligible; 187 (34%) had DM (72% type II, 26% new-onset). Pts with diabetes were older (70 vs. 68 years, p=0.006), had lower BMI (20.1 vs. 21.0, p=0.01), more multimorbidities (84% vs. 42%, p