Type 2 Diabetic Mellitus Is a Risk Factor for Nasopharyngeal Carcinoma: A 1:2 Matched Case–Control Study

Abstract

BackgroundDiabetes has been identified as an adverse prognostic variable which associated with an increased mortality in various cancers, including colorectal, lung, and breast cancers. However, previous studies provided inconsistent results on the association between diabetes and nasopharyngeal carcinoma (NPC). The main aim of this study was to investigate the associations between diabetes mellitus and the survival of NPC patients.MethodsThis study was designed as a 1:2 matched case–control study. Cases were patients who met the criteria for the diagnosis of type 2 diabetic mellitus (DM) below. Controls, matched 1:2, were patients who were normoglycemic (NDM). The survival rates were assessed by Kaplan–Meier analysis, and the survival curves were compared using a log-rank test. Multivariate analysis was conducted using the Cox proportional hazard regression model.ResultsBoth locoregional relapse-free survival (LRRFS) and disease-free survival (DFS) in the NDM group were higher than that in the DM group (p = 0.001 and p = 0.033). Additionally, subset analyses revealed that the differences in OS, LRRFS, and DFS were all significant between the two groups in the N0-N1 subset (p = 0.007, p =.000 and p = 0.002). The LRRFS was higher in the NDM group in the III-IV, T3-T4 and N0-N1 subsets (p = 0.004, p = 0.002 and p =.000). In T3-T4 subset, the NDM group experienced higher DFS than the DM group (p = 0.039). In multivariate analysis, T stage and N stage were found to be independent predictors for OS, DMFS and DFS; chemotherapy was a significant prognostic factor for DMFS and DFS, age for OS, and diabetes for LRRFS and DFS.ConclusionsType 2 diabetic mellitus is associated with poorer prognosis among patients with NPC.

Stratification of Candidates for Induction Chemotherapy in Stage III-IV Nasopharyngeal Carcinoma: A Large Cohort Study Based on a Comprehensive Prognostic Model

“…The current AJCC/UICC stage classification is the main guideline for NPC risk stratification in clinical practice. However, this classification does not consider several variables that have been suggested as prognostic factors in NPC, such as age, gender, LDH, comorbidities, and, in particular, EBV DNA (11)(12)(13). Therefore, a more comprehensive prognostic model is urgently needed to accurately predict patients' clinical outcome.…”

“…The tumor, node, metastasis (TNM) staging system, which continues to be a globally recognized standard for assessing the prognosis of NPC, has been criticized as barely satisfactory, as it does not account for important prognostic factors, such as Epstein-Barr virus (EBV) DNA and serum lactate dehydrogenase (LDH) levels (11)(12)(13). Therefore, this study aimed to evaluate several potential prognostic factors and construct a prognostic score to classify risk status and identify suitable patients with stage III-IVa NPC that could benefit from IC, using data from a large cohort of patients.…”

Impact of diabetes mellitus on the risk and survival of nasopharyngeal carcinoma: a meta-analysis

“…All studies retrospectively analyzed data. Three studies reported the median follow-up period, 20 , 21 , 23 with a range between 34.6 and 66.0 months. Four studies adopted multivariate analysis method, 19 – 22 but only one study used a matched design to select control patients.…”

“…Four studies adopted multivariate analysis method, 19 – 22 but only one study used a matched design to select control patients. 20 DM was identified in the cohorts using blood glucose test results validated by medical records in all five studies.…”

Study on the Drug Targets and Molecular Mechanisms of Rhizoma Curcumae in the Treatment of Nasopharyngeal Carcinoma Based on Network Pharmacology

“…Anti-HBV treatment may improve the prognosis of HBV-infected NPC patients [44]. Type 2 diabetes, a risk factor for NPC, is associated with a poor prognosis in NPC [45]. High-titer malaria antibodies can diagnose NPC.…”