Prognostic relevance of preoperative diabetes mellitus and the degree of hyperglycemia on the outcomes of resected pancreatic ductal adenocarcinoma

Journal of Surgical Oncology
Woohyung LeeHanlim Choi

Abstract

The prognostic relevance of preoperative diabetes mellitus (DM) on the outcomes of resected pancreatic ductal adenocarcinoma (PDAC) is controversial. Most previous studies evaluated the prognostic role of DM based on a single blood test. The participants included 147 patients with PDAC who underwent pancreatectomy between September 2003 and June 2012. They were divided into following groups according to the preoperative DM and degree of hyperglycemia defined by glycosylated hemoglobin (HbA1c): non-DM (n = 70), DM with HbA1c < 9.0% (n = 52), and DM with HbA1c ≥ 9.0% (n = 25). There were no significant differences in cancer stage or postoperative complications among the three groups. The survival rate was significantly lower in the DM with HbA1c ≥ 9.0% group (22.3%) than in the non-DM group (33.6%) and the DM with HbA1c < 9.0% group (33.8%) (P = 0.044). Multivariate analysis revealed that DM with HbA1c ≥ 9.0% (hazard ratio [HR] 2.495, 95% confidence interval [CI] 1.274-4.886, P = 0.008) and the presence of venous invasion (HR 1.836, 95%CI 1.072-3.146, P = 0.027) were independent prognostic factors for survival. Uncontrolled severe hyperglycemia rather than preoperative DM negatively affects the survival outcomes following PDAC re...Continue Reading

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Citations

Jan 6, 2018·Diabetes Therapy : Research, Treatment and Education of Diabetes and Related Disorders·Jun LuXuemei Yu
Apr 28, 2017·World Journal of Surgery·Akihiko OkamuraShinji Mine
Feb 12, 2019·Journal of Chemotherapy·Agostino MilluzzoLaura Sciacca
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Oct 11, 2017·Metabolism: Clinical and Experimental·Marco GalloAnnamaria Colao
May 6, 2021·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jason T WisemanMary Dillhoff

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