PMID- 30791870
OWN - NLM
STAT- MEDLINE
DCOM- 20190625
LR  - 20200225
IS  - 1471-2407 (Electronic)
IS  - 1471-2407 (Linking)
VI  - 19
IP  - 1
DP  - 2019 Feb 21
TI  - Fasting plasma glucose is an independent predictor of survival in patients with 
      locally advanced non-small cell lung cancer treated with concurrent 
      chemoradiotherapy.
PG  - 165
LID - 10.1186/s12885-019-5370-5 [doi]
LID - 165
AB  - BACKGROUND: Diabetes is related with increased cancer mortality across multiple 
      cancer types. Its role in lung cancer mortality is still unclear. We aim to 
      determine the prognostic value of fasting plasma glucose (FPG) and diabetes 
      mellitus in patients with locally advanced non-small cell lung cancer (NSCLC) 
      treated with concurrent chemoradiotherapy. METHODS: One-hundred seventy patients 
      with stage III NSCLC received definitive concurrent chemoradiotherapy from 2010 
      to 2014. Clinico-pathological data and clinical outcome was retrospectively 
      registered. Fifty-six patients (33%), met criteria for type 2 diabetes mellitus 
      (T2DM) at baseline. The prognostic value of FPG and other clinical variables was 
      assessed. Overall survival (OS) and progression-free survival (PFS) were 
      estimated using the Kaplan-Meier method and Cox proportional models and log-rank 
      test were used. RESULTS: With a median follow-up of 36 months, median PFS was 
      8.0 months and median OS was 15.0 months in patients with FPG >/=7 mmol/L compared 
      to 20 months (HR 1.13; 95% CI 1.07-1.19, p < 0.001) and 31 months (HR 1.09; 95% 
      CI 1.04-1.15; p < 0.001) respectively, for patients with FPG < 7 mmol/L. In the 
      multivariate analysis of the entire cohort adjusted by platinum compound and 
      comorbidities, high levels of FPG as a continuous variable (HR 1.14; 95% CI 
      1.07-1.21; p < 0.001), the presence of comorbidity (HR 1.72; 95% CI 1.12-2.63; 
      p = 0.012), and treatment with carboplatin (HR 1.95; 95% CI 1.26-2.99; p = 0.002) 
      were independent predictors for shorter OS. In additional multivariate models 
      considering non-diabetic patients as a reference group, diabetic patients with 
      poor metabolic control (HbA1c > 8.5%) (HR 4.53; 95% CI 2.21-9.30; p < 0.001) and 
      those receiving insulin (HR 3.22; 95% CI 1.90-5.46 p < 0.001) had significantly 
      independent worse OS. CONCLUSION: Baseline FPG level is an independent predictor 
      of survival in our cohort of patients with locally advanced NSCLC treated with 
      concurrent chemoradiotherapy. Studies in larger cohorts of patients are warranted 
      to confirm this relevant association.
FAU - Bergamino, Milana
AU  - Bergamino M
AD  - Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of 
      Oncology, Hospital Duran i Reynals, Avda Gran via, 199-203, L'Hospitalet, 08908, 
      Barcelona, Spain.
FAU - Rullan, Antonio J
AU  - Rullan AJ
AD  - Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of 
      Oncology, Hospital Duran i Reynals, Avda Gran via, 199-203, L'Hospitalet, 08908, 
      Barcelona, Spain.
FAU - Saigi, Maria
AU  - Saigi M
AD  - Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of 
      Oncology, Hospital Duran i Reynals, Avda Gran via, 199-203, L'Hospitalet, 08908, 
      Barcelona, Spain.
FAU - Peiro, Inmaculada
AU  - Peiro I
AD  - Clinical Nutrition Unit, Catalan Institute of Oncology, Hospital Duran i Reynals, 
      L'Hospitalet, Barcelona, Spain.
FAU - Montanya, Eduard
AU  - Montanya E
AD  - Department of Endocrinology, Hospital Universitari de Bellvitge, L'Hospitalet, 
      Barcelona, Spain.
AD  - Department of Clinical Sciences, University of Barcelona, Hospital Universitari 
      de Bellvitge, IDIBELL, CIBERDEM, L'Hospitalet, Barcelona, Spain.
FAU - Palmero, Ramon
AU  - Palmero R
AD  - Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of 
      Oncology, Hospital Duran i Reynals, Avda Gran via, 199-203, L'Hospitalet, 08908, 
      Barcelona, Spain.
FAU - Ruffinelli, Jose Carlos
AU  - Ruffinelli JC
AD  - Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of 
      Oncology, Hospital Duran i Reynals, Avda Gran via, 199-203, L'Hospitalet, 08908, 
      Barcelona, Spain.
FAU - Navarro, Arturo
AU  - Navarro A
AD  - Department of Radiation Oncology, Catalan Institute of Oncology, Hospital Duran i 
      Reynals, L'Hospitalet, Barcelona, Spain.
FAU - Arnaiz, Maria Dolores
AU  - Arnaiz MD
AD  - Department of Radiation Oncology, Catalan Institute of Oncology, Hospital Duran i 
      Reynals, L'Hospitalet, Barcelona, Spain.
FAU - Brao, Isabel
AU  - Brao I
AD  - Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of 
      Oncology, Hospital Duran i Reynals, Avda Gran via, 199-203, L'Hospitalet, 08908, 
      Barcelona, Spain.
FAU - Aso, Samantha
AU  - Aso S
AD  - Department of Respiratory Medicine, Hospital Universitari de Bellvitge, 
      L'Hospitalet, Barcelona, Spain.
FAU - Padrones, Susana
AU  - Padrones S
AD  - Department of Respiratory Medicine, Hospital Universitari de Bellvitge, 
      L'Hospitalet, Barcelona, Spain.
FAU - Cardenal, Felipe
AU  - Cardenal F
AD  - Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of 
      Oncology, Hospital Duran i Reynals, Avda Gran via, 199-203, L'Hospitalet, 08908, 
      Barcelona, Spain.
FAU - Nadal, Ernest
AU  - Nadal E
AUID- ORCID: 0000-0002-9674-5554
AD  - Department of Medical Oncology, Thoracic Oncology Division, Catalan Institute of 
      Oncology, Hospital Duran i Reynals, Avda Gran via, 199-203, L'Hospitalet, 08908, 
      Barcelona, Spain. esnadal@iconcologia.cat.
AD  - Clinical Research in Solid Tumors Group (CReST), Oncobell Program, Bellvitge 
      Biomedical Research Institute (IDIBELL), L'Hospitalet, Barcelona, Spain. 
      esnadal@iconcologia.cat.
LA  - eng
GR  - SLT006/17/00127/Department of Health Generalitat de Catalunya/
GR  - CM17/00180/Instituto de Salud Carlos III/
GR  - PI14/01109/Instituto de Salud Carlos III/
PT  - Journal Article
DEP - 20190221
PL  - England
TA  - BMC Cancer
JT  - BMC cancer
JID - 100967800
RN  - 0 (Biomarkers)
RN  - 0 (Blood Glucose)
RN  - 49DFR088MY (Platinum)
RN  - BG3F62OND5 (Carboplatin)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Biomarkers/*analysis
MH  - Blood Glucose/*analysis
MH  - Carboplatin/*therapeutic use
MH  - Carcinoma, Non-Small-Cell Lung/*diagnosis/mortality/therapy
MH  - *Chemoradiotherapy
MH  - Cohort Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Lung Neoplasms/*diagnosis/mortality/therapy
MH  - Male
MH  - Middle Aged
MH  - Platinum/*therapeutic use
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Survival Analysis
MH  - Treatment Outcome
PMC - PMC6385407
OTO - NOTNLM
OT  - Comorbidities
OT  - Concurrent chemoradiotherapy
OT  - Hyperglycemia
OT  - Locally advanced unresectable non-small cell lung cancer
OT  - Type 2 diabetes mellitus
COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The protocol of this study was 
      approved by the ethics committee of the Hospital Universitari de Bellvitge. 
      CONSENT FOR PUBLICATION: Not applicable. COMPETING INTERESTS: The authors declare 
      that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains 
      neutral with regard to jurisdictional claims in published maps and institutional 
      affiliations.
EDAT- 2019/02/23 06:00
MHDA- 2019/06/27 06:00
PMCR- 2019/02/21
CRDT- 2019/02/23 06:00
PHST- 2018/07/26 00:00 [received]
PHST- 2019/02/11 00:00 [accepted]
PHST- 2019/02/23 06:00 [entrez]
PHST- 2019/02/23 06:00 [pubmed]
PHST- 2019/06/27 06:00 [medline]
PHST- 2019/02/21 00:00 [pmc-release]
AID - 10.1186/s12885-019-5370-5 [pii]
AID - 5370 [pii]
AID - 10.1186/s12885-019-5370-5 [doi]
PST - epublish
SO  - BMC Cancer. 2019 Feb 21;19(1):165. doi: 10.1186/s12885-019-5370-5.