Confirmation of the role of diabetes in the local recurrence of surgically resected non-small cell lung cancer.

Abstract

7069 Background: We recently demonstrated that DM was an independent risk factor for LR for patients undergoing resection of NSCLC. This investigation was performed to confirm or refute this finding in a different patient cohort. Methods: Patients were eligible if they did not have a second primary cancer within five years of original diagnosis, had at least three month follow-up, and did not receive radiotherapy. There were 373 and 168 patients in the original (P1) and confirmatory (P2) cohorts, respectively, with 66 and 30 patients with DM. Chi-squared (categorical) and Kruskal-Wallis (continuous) tests were used to compare characteristics of patient groups as well as failure patterns. Results: Median follow-up was 33 months (range, 3-98 months). Patients with DM were more likely to be older and have high grade tumors, squamous cell carcinoma, and CAD than non-diabetic patients, but did not differ in rates of surgical complications, tumor size, type of resection, number of nodes resected or positive, use of chemotherapy, T, N, or overall stage, or LVI using chi-square testing. DM was an independent risk factor for LR in a Cox model in P2 (p=0.05, HR =2.15) and in P1 (p=0.008, HR=1.90), separately from BMI, glucose control, and the presence of the metabolic syndrome. The rates of LR in the combined population with DM at 2,3, and 5 years were 23%, 33%, and 56%; respectively; these rates were 15%, 19%, and 26% in nondiabetics. There was no association of available mean pre- or post-surgical (n=25 and 27, respectively) HbA1c values on the risk of LR for patients with DM or between patients receiving insulin (n=13), those receiving oral medications (n=39), or those diagnosed with the metabolic syndrome (n=48). DM did not significantly affect patterns of LR. Conclusions: DM was confirmed to be an independent predictor of the risk of LR following resection of NSCLC. No significant financial relationships to disclose.