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Erschienen in: World Journal of Surgery 10/2017

26.04.2017 | Original Scientific Report

Glycemic Status and Prognosis of Patients with Squamous Cell Carcinoma of the Esophagus

verfasst von: Akihiko Okamura, Masayuki Watanabe, Yu Imamura, Masaru Hayami, Kotaro Yamashita, Takanori Kurogochi, Shinji Mine

Erschienen in: World Journal of Surgery | Ausgabe 10/2017

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Abstract

Background

The impact of glycemic status on esophageal squamous cell carcinoma (ESCC) prognosis is unclear.

Methods

A total of 623 patients who underwent curative subtotal esophagectomy for ESCC were evaluated. Diabetes was defined as a prior diagnosis of diabetes under treatment or newly diagnosed diabetes based on preoperative glycosylated hemoglobin (HbA1c) levels. Poor glycemic control was defined as HbA1c ≥ 7.0%, whereas good glycemic control was defined as HbA1c < 7.0%. The impact of glycemic status on long-term survival after esophagectomy was evaluated.

Results

Among the 623 patients, 64 (10.3%) had diabetes including 30 (4.8%) with poor glycemic control. Although diabetes did not influence patient survival, patients with poor glycemic control had worse overall and disease-specific survival compared with those with good glycemic control (P = 0.011 and 0.039, respectively). Comparing poor glycemic control with good glycemic control, the hazard ratios (HRs) for overall and disease-specific mortality were 1.91 (1.15–3.18) and 1.89 (1.02–3.49) in univariate analysis. After multivariate adjustment, poor glycemic control also had increased risk of overall and disease-specific mortality [HR 1.72 (95% CI 1.02–2.88) and 1.65 (95% CI 0.89–3.08), respectively]. Poor glycemic control did not increase the risk of overall or disease-specific mortality in patients with stages 0–II disease but significantly increased this risk in those with stages III–IV disease [HR 2.05 (1.14–3.69) and 1.95 (1.01–3.80), respectively].

Conclusions

Poor glycemic control is an independent risk factor for overall and disease-specific mortality after esophagectomy for advanced-stage ESCC.
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Metadaten
Titel
Glycemic Status and Prognosis of Patients with Squamous Cell Carcinoma of the Esophagus
verfasst von
Akihiko Okamura
Masayuki Watanabe
Yu Imamura
Masaru Hayami
Kotaro Yamashita
Takanori Kurogochi
Shinji Mine
Publikationsdatum
26.04.2017
Verlag
Springer International Publishing
Erschienen in
World Journal of Surgery / Ausgabe 10/2017
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI
https://doi.org/10.1007/s00268-017-4036-1

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