INTRODUCTION: The prognostic relevance of preoperative diabetes mellitus (DM) on the outcomes of resected pancreatic ductal adenocarcinoma (PDAC) is controversial. Most previous studies evaluated the prognostic role of DM based on a single blood test. METHODS: The participants included 147 patients with PDAC who underwent pancreatectomy between September 2003 and June 2012. They were divided into following groups according to the preoperative DM and degree of hyperglycemia defined by glycosylated hemoglobin (HbA1c): non-DM (n = 70), DM with HbA1c < 9.0% (n = 52), and DM with HbA1c ≥ 9.0% (n = 25). RESULTS: There were no significant differences in cancer stage or postoperative complications among the three groups. The survival rate was significantly lower in the DM with HbA1c ≥ 9.0% group (22.3%) than in the non-DM group (33.6%) and the DM with HbA1c < 9.0% group (33.8%) (P = 0.044). Multivariate analysis revealed that DM with HbA1c ≥ 9.0% (hazard ratio [HR] 2.495, 95% confidence interval [CI] 1.274-4.886, P = 0.008) and the presence of venous invasion (HR 1.836, 95%CI 1.072-3.146, P = 0.027) were independent prognostic factors for survival. CONCLUSION: Uncontrolled severe hyperglycemia rather than preoperative DM negatively affects the survival outcomes following PDAC resection.
INTRODUCTION: The prognostic relevance of preoperative diabetes mellitus (DM) on the outcomes of resected pancreatic ductal adenocarcinoma (PDAC) is controversial. Most previous studies evaluated the prognostic role of DM based on a single blood test. METHODS: The participants included 147 patients with PDAC who underwent pancreatectomy between September 2003 and June 2012. They were divided into following groups according to the preoperative DM and degree of hyperglycemia defined by glycosylated hemoglobin (HbA1c): non-DM (n = 70), DM with HbA1c < 9.0% (n = 52), and DM with HbA1c ≥ 9.0% (n = 25). RESULTS: There were no significant differences in cancer stage or postoperative complications among the three groups. The survival rate was significantly lower in the DM with HbA1c ≥ 9.0% group (22.3%) than in the non-DM group (33.6%) and the DM with HbA1c < 9.0% group (33.8%) (P = 0.044). Multivariate analysis revealed that DM with HbA1c ≥ 9.0% (hazard ratio [HR] 2.495, 95% confidence interval [CI] 1.274-4.886, P = 0.008) and the presence of venous invasion (HR 1.836, 95%CI 1.072-3.146, P = 0.027) were independent prognostic factors for survival. CONCLUSION: Uncontrolled severe hyperglycemia rather than preoperative DM negatively affects the survival outcomes following PDAC resection.
Authors: Jason T Wiseman; Jeffery Chakedis; Eliza W Beal; Anghela Paredes; Amy McElhany; Andrew Fang; Andrei Manilchuk; Christopher Ellison; George Van Buren; Timothy M Pawlik; Carl R Schmidt; William E Fisher; Mary Dillhoff Journal: J Gastrointest Surg Date: 2021-05-04 Impact factor: 3.452
Authors: Anna Badowska-Kozakiewicz; Marta Fudalej; Daria Kwaśniewska; Marek Durlik; Anna Nasierowska-Guttmejer; Agata Mormul; Emilia Włoszek; Aleksandra Czerw; Tomasz Banaś; Andrzej Deptała Journal: Cancers (Basel) Date: 2022-06-08 Impact factor: 6.575