Francesc Xavier Avilés-Jurado1,2, Joan Carles Flores2,3, Josep Gumà4, Victoria Ceperuelo-Mallafré5, Raquel Casanova-Marqués6, David Gómez7, Joan Josep Vendrell5,8, Xavier León9, Isabel Vilaseca1,10, Ximena Terra11. 1. Otorhinolaryngology Head and Neck Surgery Department, Hospital Clínic, Barcelona, Catalonia. 2. HJ23 Otolaryngology Disease Research Group, Insitut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Catalonia, Spain. 3. Otorhinolaryngology Head and Neck Surgery Department, Hospital Universitari de Tarragona Joan XXIII, Insitut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Catalonia, Spain. 4. Oncology Department, IISPV, Universitat Rovira I Virgili, Hospital Universitari Sant Joan de Reus, Catalonia, Spain. 5. Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas (CIBERDEM), Madrid, Spain. 6. School of Medicine, Universitat Rovira Virgili, Tarragona, Catalonia, Spain. 7. Radiation Oncology Department, Hospital Universitari Sant Joan de Reus, Catalonia, Spain. 8. Endocrinology Department, Hospital Universitari de Tarragona Joan XXIII, Insitut d'Investigació Sanitària Pere Virgili, Universitat Rovira i Virgili, Tarragona, Catalonia, Spain. 9. Otorhinolaryngology Head and Neck Surgery Department, Hospital de la Santa Creu i Sant Pau and Networking Research Center on Bioengineering, Biomaterials and Nanomedicine (CIBER-BBN, MICINN, ISCIII), Universitat Autònoma de Barcelona, Barcelona, Spain. 10. Centro de Investigación Biomédica en Red de enfermedades Respiratorias (CIBER-Res), Universitat de Barcelona, Barcelona, Spain. 11. MoBioFood Research Group, Biochemistry and Biotechnology Department, Universitat Rovira i Virgili, Campus Sescel·lades, Tarragona, Spain.
Abstract
BACKGROUND: The primary purpose of this study was to investigate the significance of pretreatment glycemic parameters in the prognosis of head and neck squamous cell carcinoma (HNSCC). METHODS: Plasma samples of 71 patients with untreated HNSCC were obtained at the time of diagnosis. The prognostic value of fasting insulin, glucose, glycosylated hemoglobin levels, and the homeostatic model of risk assessment-insulin resistance (HOMA-IR) was evaluated toward disease-free survival. RESULTS: High HOMA-IR levels were associated with poor disease-free survival in intermediate-advanced stage tumors. Kaplan-Meier curves showed lower disease-free survival rates in patients with high HOMA-IR than in patients with low levels. In patients with intermediate-advanced stage tumors, multivariate analysis revealed that those with an HOMA-IR >2.974 presented a 2.7 times higher risk of poor outcome (95% confidence interval [CI] 1.023-7.341; P = .045). CONCLUSION: The HOMA-IR is independently associated with disease-free survival in patients with HNSCC. We found an optimal HOMA-IR cutoff value for disease-free survival in patients with intermediate-advanced HNSCC.
BACKGROUND: The primary purpose of this study was to investigate the significance of pretreatment glycemic parameters in the prognosis of head and neck squamous cell carcinoma (HNSCC). METHODS: Plasma samples of 71 patients with untreated HNSCC were obtained at the time of diagnosis. The prognostic value of fasting insulin, glucose, glycosylated hemoglobin levels, and the homeostatic model of risk assessment-insulin resistance (HOMA-IR) was evaluated toward disease-free survival. RESULTS: High HOMA-IR levels were associated with poor disease-free survival in intermediate-advanced stage tumors. Kaplan-Meier curves showed lower disease-free survival rates in patients with high HOMA-IR than in patients with low levels. In patients with intermediate-advanced stage tumors, multivariate analysis revealed that those with an HOMA-IR >2.974 presented a 2.7 times higher risk of poor outcome (95% confidence interval [CI] 1.023-7.341; P = .045). CONCLUSION: The HOMA-IR is independently associated with disease-free survival in patients with HNSCC. We found an optimal HOMA-IR cutoff value for disease-free survival in patients with intermediate-advanced HNSCC.