Abstract
Studies showing that individuals with non-small cell lung cancer (NSCLC) and diabetes mellitus (DM) have reported poor outcomes after pulmonary resection with varying results. Therefore, we investigated the clinical impact of preoperative DM on postoperative morbidity and survival in individuals with resectable NSCLC. Data of individuals who underwent pulmonary resection for NSCLC from 2000 to 2015 were extracted from the database of Kyoto University Hospital. The primary endpoint was the incidence of postoperative complications, and secondary endpoints were postoperative length of hospital stay and overall survival. The survival rate was analyzed using the Kaplan-Meier method. A total of 2,219 patients were eligible for the study. The median age of participants was 67 years. Among them, 39.5% were women, and 259 (11.7%) presented with DM. The effect of DM on the incidence of postoperative complications and postoperative length of hospital stay was not significant. Although the 5-year survival rates were similar in both patients with and without DM (80.2% versus 79.4%; p = 0.158), those with DM who had a hemoglobin A1c level ≥ 8.0% had the worst survival. In individuals with resectable NSCLC, preoperative DM does not influence the acute phase postoperative recovery. However, poorly controlled preoperative DM could lead to low postoperative survival rates.
Highlights
Lung cancer is the leading cause of cancer-related deaths worldwide [1]
The 5-year survival rates were similar in both patients with and without diabetes mellitus (DM) (80.2% versus 79.4%; p = 0.158), those with DM who had a hemoglobin A1c level 8.0% had the worst survival
Poorly controlled preoperative DM could lead to low postoperative survival rates
Summary
Lung cancer is the leading cause of cancer-related deaths worldwide [1]. Epidemiologic evidence has indicated that individuals with DM are at a significantly high risk of cancer, such as pancreatic, hepatic, colorectal, breast, urinary tract, and endometrial cancers [7]. A recent meta-analysis has shown that DM might increase the risk of lung cancer, among women [9]. The most recent large-scale cohort study of an Asian population has shown that DM was not statistically significantly associated with the risk of death from nonsmall cell lung cancer (NSCLC) [13]. In Japan, lung cancer is the leading cause of death in individuals with DM complicated by malignant neoplasia [14]
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