Prognostic factors for resected non‐small cell lung cancer in patients with type 2 diabetes mellitus

Yu, Woo Sik; Lee, Chang Young; Park, Sung Yong; Suh, Jeewon; Narm, Kyoung Shik; Kim, Dae Joon; Chung, Kwansoo; Lee, Jin Gu

doi:10.1002/jso.24989

Cited by 15 publications

(13 citation statements)

References 29 publications

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“…survival than those with HbA1c levels < 7.0%; meanwhile, those with HbA1c levels � 8.0% had the worst survival. To achieve improved survival, proper glycemic control (HbA1c levels < 7%) is recommended for individuals with DM undergoing lung cancer operations [30]. In contrast, DM has no effect on the survival of individuals undergoing resection for stage I NSCLC [22] and long-term (60-month) survival [21].…”

Section: Plos Onementioning

confidence: 99%

Impact of diabetes mellitus on postoperative outcomes in individuals with non-small-cell lung cancer: A retrospective cohort study

et al. 2020

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Objectives Studies showing that individuals with non-small cell lung cancer (NSCLC) and diabetes mellitus (DM) have reported poor outcomes after pulmonary resection with varying results. Therefore, we investigated the clinical impact of preoperative DM on postoperative morbidity and survival in individuals with resectable NSCLC. Patients and methods Data of individuals who underwent pulmonary resection for NSCLC from 2000 to 2015 were extracted from the database of Kyoto University Hospital. The primary endpoint was the incidence of postoperative complications, and secondary endpoints were postoperative length of hospital stay and overall survival. The survival rate was analyzed using the Kaplan–Meier method. Results A total of 2,219 patients were eligible for the study. The median age of participants was 67 years. Among them, 39.5% were women, and 259 (11.7%) presented with DM. The effect of DM on the incidence of postoperative complications and postoperative length of hospital stay was not significant. Although the 5-year survival rates were similar in both patients with and without DM (80.2% versus 79.4%; p = 0.158), those with DM who had a hemoglobin A1c level ≥ 8.0% had the worst survival. Conclusions In individuals with resectable NSCLC, preoperative DM does not influence the acute phase postoperative recovery. However, poorly controlled preoperative DM could lead to low postoperative survival rates.

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Section: Plos Onementioning

confidence: 99%

Impact of diabetes mellitus on postoperative outcomes in individuals with non-small-cell lung cancer: A retrospective cohort study

et al. 2020

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“…Recent studies suggest an association between diabetes and lung cancer, providing epidemiological and clinical support for the hypothesis that diabetes is a risk factor for lung cancer [90]. Diabetes may influence lung cancer progression and outcome, and may serve as a poor prognostic factor for lung cancer [83].…”

Section: Introductionmentioning

confidence: 92%

“…Proper glycemic control for lung cancer patients is required to induce antineoplastic effects and increase survival (HZ of 0.62) [90]. Diabetic patients have been shown to be more vulnerable to radiation [91].…”

Section: Clinical Presentationmentioning

confidence: 99%

Diabetes and Lung Disease: A Neglected Relationship

Khateeb¹,

Fuchs²,

Khamaisi³

2018

Rev Diabet Stud

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BACKGROUND: Diabetes mellitus is a systemic disorder associated with inflammation and oxidative stress which may target many organs such as the kidney, retina, and the vascular system. The pathophysiology, mechanisms, and consequences of diabetes on these organs have been studied widely. However, no work has been done on the concept of the lung as a target organ for diabetes and its implications for lung diseases. AIM: In this review, we aimed to investigate the effects of diabetes and hypoglycemic agent on lung diseases, including asthma, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, pulmonary hypertension, and lung cancer. We also reviewed the potential mechanisms by which these effects may affect lung disease patients. RESULTS: Our results suggest that diabetes can affect the severity and clinical course of several lung diseases. CONCLUSIONS: Although the diabetes-lung association is epidemiologically and clinically well-established, especially in asthma, the underlying mechanism and pathophysiology are not been fully understood. Several mechanisms have been suggested, mainly associated with the proinflammatory and proliferative properties of diabetes, but also in relation to micro-and macrovascular effects of diabetes on the pulmonary vasculature. Also, hypoglycemic drugs may influence lung diseases in different ways. For example, metformin was considered a potential therapeutic agent in lung diseases, while insulin was shown to exacerbate lung diseases; this suggests that their effects extend beyond their hypoglycemic properties.

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“…Recently, there have been many studies on the prognostic factors for patients with resected NSCLC [4–7]. Prognostic factors can be divided into clinical factors, tumor-related factors and treatment-related factors.…”

Section: Introductionmentioning

confidence: 99%

“…Eligibility criteria included the following: [1] histological diagnosis of NSCLC; [2] suffering from only single primary NSCLC in their lifetime and had NSCLC between 2004 and 2014; [3] received resection only; [4] had definitive surgical information; [5] survival time equal to or greater than one month; and [6] ≥20 years old. Moreover, the following criteria were used to exclude patients from the study: [1] M 1 stage or without definitive information on M stage; [2] without definitive information on primary site, laterality or histological grade; [3] with T 4>7 and without definitive information on tumor size; [4] with T 4 Inv , T 4 Ipsi Nod and without definitive information on tumor extension; [5] with N 3 stage or without definitive information on N stage; [6] without definitive information on the number of examined and positive regional lymph nodes; [7] unknown marital status and race. Figure 1 shows the flow chart of the process used to screen patients according to the inclusion and exclusion criteria.…”

Section: Introductionmentioning

confidence: 99%

RNSCLC-PRSP software to predict the prognostic risk and survival in patients with resected T1-3N0–2 M0 non-small cell lung cancer

Zhang

et al. 2019

BioData Mining

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Background The clinical outcomes of patients with resected T 1-3 N 0–2 M 0 non-small cell lung cancer (NSCLC) with the same tumor-node-metastasis (TNM) stage are diverse. Although other prognostic factors and prognostic prediction tools have been reported in many published studies, a convenient, accurate and specific prognostic prediction software for clinicians has not been developed. The purpose of our research was to develop this type of software that can analyze subdivided T and N staging and additional factors to predict prognostic risk and the corresponding mean and median survival time and 1–5-year survival rates of patients with resected T 1-3 N 0–2 M 0 NSCLC. Results Using a Cox proportional hazard regression model, we determined the independent prognostic factors and obtained a prognostic index (PI) eq. PI = ∑ βixi . =0.379X 1 –0.403X 2 –0.267X 51 –0.167X 61 –0.298X 62 + 0.460X 71 + 0.617X 72 –0.344X 81 –0.105X 91 –0.243X 92 + 0.305X 101 + 0.508X 102 + 0.754X 103 + 0.143X 111 + 0.170X 112 + 0.434X 113 –0.327X 122 –0.247X 123 + 0.517X 133 + 0.340X 134 + 0.457X 143 + 0.419X 144 + 0.407X 145 . Using the PI equation, we determined the PI value of every patient. According to the quantile of the PI value, patients were divided into three risk groups: low-, intermediate-, and high-risk groups with significantly different survival rates. Meanwhile, we obtained the mean and median survival times and 1–5-year survival rates of the three groups. We developed the RNSCLC-PRSP software which is freely available on the web at http://www.rnsclcpps.com with all major browsers supported to determine the prognostic risk and associated survival of patients with resected T 1-3 N 0–2 M 0 non-small cell lung cancer. Conclusions After prognostic factor analysis, prognostic risk grouping and corresponding survival assessment, we developed a novel software program. It is practical and convenient for clinicians to evaluate the prognostic risk and corresponding survival of patients with resected T 1-3 N ...

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Prognostic factors for resected non‐small cell lung cancer in patients with type 2 diabetes mellitus

Cited by 15 publications

References 29 publications

Impact of diabetes mellitus on postoperative outcomes in individuals with non-small-cell lung cancer: A retrospective cohort study

Impact of diabetes mellitus on postoperative outcomes in individuals with non-small-cell lung cancer: A retrospective cohort study

Diabetes and Lung Disease: A Neglected Relationship

RNSCLC-PRSP software to predict the prognostic risk and survival in patients with resected T1-3N0–2 M0 non-small cell lung cancer

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