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糖尿病对非小细胞肺癌患者术后结局的影响:一项回顾性队列研究。

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

机构信息

Division of Thoracic Surgery, National Hospital Organization Nagara Medical Center, Gifu, Japan.

Department of Thoracic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.

出版信息

PLoS One. 2020 Nov 9;15(11):e0241930. doi: 10.1371/journal.pone.0241930. eCollection 2020.

Abstract

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.

摘要

目的

研究表明,患有非小细胞肺癌(NSCLC)和糖尿病(DM)的个体在接受肺切除术后报告了不同的结果,预后较差。因此,我们研究了术前 DM 对可切除 NSCLC 患者术后发病率和生存的临床影响。

患者和方法

从京都大学医院的数据库中提取了 2000 年至 2015 年期间接受 NSCLC 肺切除术的个体数据。主要终点是术后并发症的发生率,次要终点是术后住院时间和总生存率。使用 Kaplan-Meier 方法分析生存率。

结果

共有 2219 名患者符合研究条件。参与者的中位年龄为 67 岁。其中,女性占 39.5%,259 例(11.7%)患有 DM。DM 对术后并发症发生率和术后住院时间的影响不显著。尽管 DM 患者的 5 年生存率与无 DM 患者相似(80.2%对 79.4%;p=0.158),但糖化血红蛋白水平≥8.0%的 DM 患者的生存最差。

结论

在可切除 NSCLC 患者中,术前 DM 并不影响急性术后恢复。然而,术前控制不佳的 DM 可能导致术后生存率降低。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bb7a/7652320/1034ce2758fd/pone.0241930.g001.jpg

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