High pre-operative fasting blood glucose levels predict a poor prognosis in patients with pancreatic neuroendocrine tumo
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ORIGINAL ARTICLE
High pre-operative fasting blood glucose levels predict a poor prognosis in patients with pancreatic neuroendocrine tumour Yitao Gong1,2,3,4 Zhiyao Fan1,2,3,4 Pin Zhang1,2,3,4 Yunzhen Qian1,2,3,4 Qiuyi Huang1,2,3,4 Shengming Deng1,2,3,4 Guopei Luo1,2,3,4 He Cheng1,2,3,4 Kaizhou Jin1,2,3,4 Quanxing Ni1,2,3,4 Xianjun Yu1,2,3,4 Chen Liu1,2,3,4 ●
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Received: 7 May 2020 / Accepted: 19 August 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Hyperglycaemia has been indicated as a pro-tumoural factor; however, the prognostic role of diabetes mellitus (DM) in pancreatic neuroendocrine tumours (panNETs) remains ambiguous, partly due to the effects of anti-diabetic drugs. We hypothesise that the blood sugar level per se affects the outcome of panNETs, and thus, we investigated the prognostic significance of the fasting blood glucose (FBG) level in resected panNET patients with no pre-existing DM. Methods A retrospective cohort study comprising 201 patients with radically resected non-functional panNETs was conducted. A total of 164 patients without pre-existing DM were further studied. An FBG level greater than 5.6 mmol/L was defined as high (otherwise, normal). Survival was evaluated using Kaplan–Meier methods and log-rank tests. Multivariate analyses for survival were performed using the Cox regression model. Results High FBG levels were significantly associated with poor overall survival (OS; p = 0.019) and recurrence-free survival (RFS; p = 0.011) in resected patients with panNET who had no pre-existing DM. The multivariable-adjusted hazard ratios (HRs) for mortality and recurrence comparing patients with high and normal FBG levels were 12.19 (95% confidence interval (CI) = 1.15–128.78, p = 0.038) and 2.43 (95% CI = 1.03–5.72, p = 0.042), respectively. Conclusion A pre-operative FBG level greater than 5.6 mmol/L is associated with poor OS and RFS metastasis for patients with panNET who undergo radical surgical resection. Keywords Hyperglycaemia Diabetes mellitus Prediabetes Impaired glucose tolerance ●
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Introduction These authors contributed equally: Yitao Gong, Zhiyao Fan, Pin Zhang Supplementary information The online version of this article (https:// doi.org/10.1007/s12020-020-02469-0) contains supplementary material, which is available to authorised users. * Xianjun Yu [email protected] * Chen Liu [email protected] 1
Department of Pancreatic Surgery, Fudan University Shanghai Cancer Center, 200032 Shanghai, China
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Department of Oncology, Shanghai Medical College, Fudan University, 200032 Shanghai, China
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Shanghai Pancreatic Cancer Institute, 200032 Shanghai, China
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Pancreatic Cancer Institute, Fudan University, 200032 Shanghai, China
Pancreatic neuroendocrine neoplasms (panNENs) are uncommon neuroendocrine neoplasms that arise in the islet of Langerhans [1]. PanNENs constitute 5.60 mmol/L). The median FBG levels (total range) in the normal and high FBG groups were 5.11 mmo
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