Impact of diabetes and hyperglycemia on survival in advanced breast cancer patients.

Experimental Diabetes Research Pub Date : 2012-01-01 Epub Date: 2012-07-31 DOI:10.1155/2012/732027
Cynthia Villarreal-Garza, Robin Shaw-Dulin, Fernando Lara-Medina, Ludwing Bacon, Daniel Rivera, Lorena Urzua, Christian Aguila, Rebeca Ramirez-Morales, Julieta Santamaria, Enrique Bargallo, Alejandro Mohar, Luis A Herrera
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引用次数: 93

Abstract

Purpose: We examined the impact of diabetes and hyperglycemia on cancer-specific survival of patients with metastatic or recurrent breast cancer (BC).

Methods: We performed a retrospective analysis of 265 patients with advanced BC receiving palliative chemotherapy. BC-specific mortality was compared for diabetic and nondiabetic patients as well as for patients that presented hyperglycemia during treatment.

Results: No difference was observed between the diabetic and nondiabetic patients in terms of overall survival (OS). A difference in OS was observed between nondiabetic patients and diabetic patients who had hyperglycemia. The OS was greater in diabetic patients with proper metabolic control than diabetic patients with hyperglycemia. The risk of death was higher in patients with mean glucose levels >130 mg/dL during treatment. Several factors were associated with poor OS: tumor stage, hormone-receptor-negative tumors, HER2 negative disease, multiple metastatic sites, presence of visceral metastases, and mean glucose >130 mg/dL.

Conclusion: Elevated glucose levels are associated with a poor outcome in diabetic and nondiabetic patients in contrast to patients with normoglycemic levels, conferring an elevated risk of death. According to these results, clinicians should monitor glucose levels during treatment for advanced breast cancer disease and take action to maintain normal glucose levels.

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糖尿病和高血糖对晚期乳腺癌患者生存的影响。
目的:我们研究了糖尿病和高血糖对转移性或复发性乳腺癌(BC)患者癌症特异性生存的影响。方法:我们对265例接受姑息性化疗的晚期BC患者进行回顾性分析。比较了糖尿病患者和非糖尿病患者以及在治疗期间出现高血糖的患者的bc特异性死亡率。结果:糖尿病患者和非糖尿病患者在总生存期(OS)方面无差异。在非糖尿病患者和有高血糖的糖尿病患者之间观察到OS的差异。代谢控制良好的糖尿病患者的OS高于高血糖患者。治疗期间平均血糖水平>130 mg/dL的患者死亡风险更高。与不良OS相关的几个因素:肿瘤分期、激素受体阴性肿瘤、HER2阴性疾病、多个转移部位、内脏转移的存在和平均葡萄糖>130 mg/dL。结论:与血糖水平正常的患者相比,糖尿病和非糖尿病患者的血糖水平升高与预后不良相关,导致死亡风险增加。根据这些结果,临床医生应该在治疗晚期乳腺癌疾病期间监测血糖水平,并采取措施维持正常的血糖水平。
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Experimental Diabetes Research
Experimental Diabetes Research 医学-内分泌学与代谢
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