Yu Woo Sik, Lee Chang Young, Park Seong Yong, Suh Jee Won, Narm Kyoung Shik, Kim Dae Joon, Chung Kyung Young, Lee Jin Gu
Department of Medicine, The Graduate School of Yonsei University, Seoul, Republic of Korea.
Department of Thoracic Surgery, Armed Forces Capital Hospital, Seongnam-si, Gyunggi-do, Republic of Korea.
J Surg Oncol. 2018 Apr;117(5):985-993. doi: 10.1002/jso.24989. Epub 2018 Feb 6.
For diabetic patients with lung cancer, blood glucose levels and medications such as metformin and statins may influence survival.
This study aimed to determine prognostic survival factors for diabetic patients with resected non-small cell lung cancer.
Between January 2005 and December 2013, 301 patients with type 2 diabetes mellitus who underwent curative resection for non-small cell lung cancer were identified and reviewed retrospectively.
The median follow-up period was 48 months. In multivariate analysis for lung cancer-specific survival, older age, forced expiratory volume in 1 s (FEV1) <80% predicted, and advanced pathologic stage were significant negative prognostic factors; statin use was a positive prognostic factor (hazard ratio (HR), 0.468). In multivariate analysis for overall survival, male sex, older age, comorbidity index, and advanced pathologic stage were significant negative prognostic factors and proper glycemic control (HR, 0.621) and statin use (HR, 0.585) were positive prognostic factors.
Proper glycemic control (glycated hemoglobin A1c <7%) is recommended for diabetic patients undergoing lung cancer operations. Further studies are required to elucidate associations between type 2 diabetes mellitus and antineoplastic effects of statins and to evaluate statins as a novel adjuvant treatment for lung cancer.
对于患有肺癌的糖尿病患者,血糖水平以及二甲双胍和他汀类药物等药物可能会影响生存期。
本研究旨在确定接受手术切除的非小细胞肺癌糖尿病患者的预后生存因素。
回顾性分析2005年1月至2013年12月期间301例接受非小细胞肺癌根治性切除术的2型糖尿病患者。
中位随访期为48个月。在肺癌特异性生存的多因素分析中,年龄较大、第1秒用力呼气量(FEV1)<80%预计值以及病理分期较晚是显著的负性预后因素;使用他汀类药物是正性预后因素(风险比(HR),0.468)。在总生存的多因素分析中,男性、年龄较大、合并症指数以及病理分期较晚是显著的负性预后因素,血糖控制良好(HR,0.621)和使用他汀类药物(HR,0.585)是正性预后因素。
建议接受肺癌手术的糖尿病患者进行良好的血糖控制(糖化血红蛋白A1c<7%)。需要进一步研究以阐明2型糖尿病与他汀类药物抗肿瘤作用之间的关联,并评估他汀类药物作为肺癌新型辅助治疗的效果。