Division of Thoracic Surgery, Keio University School of Medicine, Tokyo, Japan.
Department of Pathology, Keio University Hospital, Tokyo, Japan.
J Surg Oncol. 2021 Jan;123(1):332-341. doi: 10.1002/jso.26243. Epub 2020 Oct 1.
The aim of this study was to investigate the clinicopathological and prognostic features of operable non-small cell lung cancer (NSCLC) patients with diabetes mellitus (DM).
A total of 1231 surgically resected NSCLC patients were retrospectively reviewed. Clinicopathological characteristics were compared between patients with DM (DM group, n = 139) and those without DM (non-DM group, n = 1092). The clinical factors associated with postoperative complications and prognostic factors were identified.
The DM group had distinct clinicopathological features. No significant differences in histological invasiveness or stage were found. The presence and control status of DM were independent predictors of postoperative complications. No significant differences in recurrence-free survival or cancer-specific survival were observed; however, the DM group had worse overall survival (OS). The DM group had a higher number of deaths from other diseases than the non-DM group, and these patients had significantly higher postoperative hemoglobin A1c levels than patients with cancer-related death.
The presence and control status of preoperative DM are useful predictors of both postoperative complications and OS in operable NSCLC patients. Concomitant diabetes-related complications have a negative effect on long-term survival in diabetic NSCLC patients, and long-term glycemic control is important to prolong OS.
本研究旨在探讨合并糖尿病的可手术非小细胞肺癌(NSCLC)患者的临床病理特征和预后特点。
回顾性分析 1231 例接受手术治疗的 NSCLC 患者的临床资料。比较合并糖尿病(DM 组,n=139)和未合并糖尿病(非 DM 组,n=1092)患者的临床病理特征。分析与术后并发症相关的临床因素及预后因素。
DM 组具有独特的临床病理特征。两组间组织学侵袭性和分期无显著差异。DM 的存在和控制情况是术后并发症的独立预测因素。两组患者在无复发生存和癌症特异性生存方面无显著差异,但 DM 组的总生存较差。DM 组因其他疾病导致的死亡例数多于非 DM 组,且这些患者的术后糖化血红蛋白水平显著高于因癌症相关死亡的患者。
术前 DM 的存在和控制情况是可手术 NSCLC 患者术后并发症和总生存的有用预测指标。合并糖尿病相关并发症对糖尿病 NSCLC 患者的长期生存有负面影响,长期血糖控制对延长总生存至关重要。