Du Ting, Zha Xueli, Zhang Yawen, Huang Qin
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, PR China.
Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, PR China.
Cancer Treat Res Commun. 2025;44:100980. doi: 10.1016/j.ctarc.2025.100980. Epub 2025 Aug 8.
Recent studies have shown that chemotherapy can cause abnormal glucose metabolism in cancer patients; however, little is known about the association of blood glucose (BG) with chemotherapy in ovarian cancer. In this study, we investigated the effect of chemotherapy on glucose metabolism in patients with advanced ovarian cancer and its effect on patient prognosis.
We retrospectively analyzed blood glucose and other clinical data from 100 patients with advanced ovarian cancer (International Federation of Gynecology and Obstetrics, FIGO III/IV) before and after chemotherapy. Kaplan-Meier survival curves were used to calculate OS Overall Survival) survival curves for patients in the BG-High and BG-Low groups, and logarithmic rank statistics (Mantel-Cox) to assess associations between clinical outcomes and related indicators of patients.
Of the 100 patients with advanced ovarian cancer (OC) included in this study, 49 patients (49 %) had stage III disease, and 51 had stage IV disease according to FIGO classification. In total, 65 patients (65 %) achieved R0 surgical resection, while 35 patients (35 %) achieved R1, after complete surgical resection or satisfactory cytoreductive surgery followed by paclitaxel-carboplatin chemotherapy every three weeks for a total of six cycles. According to blood glucose (BG) levels after chemotherapy, patients were divided into two groups: blood glucose ≥ 6.1mmol/L (BG High) and blood glucose < 6.1mmol/L (BG Low). Thirty-two patients (BG High) had elevated fasting blood glucose levels after chemotherapy. Of these, six patients were definitively diagnosed with diabetes, fasting BG ≥7.0 mmol/L, and 26 patients had impaired fasting blood glucose, fasting BG 6.1-6.9 mmol/L; this difference was statistically significant (P < 0.05). Kaplan-Meier analysis showed that the mean 5-year OS (probability of survival from diagnosis to 5 years post-treatment) of 100 patients with OC in this study were 33 months. The mean OS of patients in the BG-LOW group was 37 months compared to 28 months in the BG-High group; this difference was statistically significant (P <0.01). The Cox regression model indicated that post-chemotherapy blood glucose levels exerted an independent effect on OS in OC patients (hazard ratio [HR]: 3.4; 95 % confidence interval [CI]: 2.0-5.7; P < 0.01). In addition, FIGO staging and surgical R0 resection also exerted independent effects on patient survival.
Patients with advanced ovarian cancer experience hyperglycemia during adjuvant chemotherapy. Furthermore, an increase in blood glucose after chemotherapy is associated with a poor prognosis. Our findings identified potential chemotherapy risks and highlighted the importance of preventing hyperglycemia.
近期研究表明化疗可导致癌症患者出现糖代谢异常；然而，关于卵巢癌患者血糖（BG）与化疗之间的关联却知之甚少。在本研究中，我们调查了化疗对晚期卵巢癌患者糖代谢的影响及其对患者预后的影响。
我们回顾性分析了100例晚期卵巢癌患者（国际妇产科联盟，FIGO III/IV期）化疗前后的血糖及其他临床数据。采用Kaplan-Meier生存曲线计算高血糖组（BG-High）和低血糖组（BG-Low）患者的总生存期（OS）生存曲线，并采用对数秩检验（Mantel-Cox）评估患者临床结局与相关指标之间的关联。
本研究纳入的100例晚期卵巢癌患者中，根据FIGO分期，49例（49%）为III期疾病，51例为IV期疾病。总共65例患者（65%）实现了R0手术切除，而35例患者（35%）实现了R1切除，所有患者均接受了完全手术切除或满意的肿瘤细胞减灭术，随后每三周进行一次紫杉醇-卡铂化疗，共六个周期。根据化疗后的血糖（BG）水平，将患者分为两组：血糖≥6.1mmol/L（高血糖组）和血糖<6.1mmol/L（低血糖组）。32例患者（高血糖组）化疗后空腹血糖水平升高。其中，6例患者被确诊为糖尿病，空腹血糖≥7.0 mmol/L，26例患者空腹血糖受损，空腹血糖为6.1-6.9 mmol/L；差异具有统计学意义（P < 0.05）。Kaplan-Meier分析显示，本研究中100例卵巢癌患者的平均5年总生存期（从诊断到治疗后5年的生存概率）为33个月。低血糖组患者的平均总生存期为37个月，而高血糖组为28个月；差异具有统计学意义（P <0.01）。Cox回归模型表明，化疗后血糖水平对卵巢癌患者的总生存期具有独立影响（风险比[HR]：3.4；95%置信区间[CI]：2.0-5.7；P < 0.01）。此外，FIGO分期和手术R0切除对患者生存也具有独立影响。
晚期卵巢癌患者在辅助化疗期间会出现高血糖。此外，化疗后血糖升高与预后不良相关。我们的研究结果确定了潜在的化疗风险，并强调了预防高血糖的重要性。
