Abstract
Purpose The relationship between high blood glucose and colorectal cancer (CRC) has been studied, but the role of postoperative fasting blood glucose (FBG) in patients with a prior normal FBG has never been addressed. Methods A total of 120 CRC patients staged I-III were enrolled, and the prognostic value of postoperative FBG for disease-free survival (DFS) was determined by Kaplan-Meier analysis. Univariate and multivariate analyses were conducted to test other clinicopathological parameters, including preoperative hemoglobin (HGB) and the neutrophil-lymphocyte ratio (NLR). Results By a cut-off point of 5.11 mmol/L, 51 and 69 patients were divided into low postoperative FBG (<5.11 mmol/L) and high postoperative FBG (≥5.11 mmol/L) groups, respectively. A high postoperative FBG was more common in older age (P = 0.01), left-located tumor (P = 0.02), smaller tumor diameter (P = 0.01), node negative involvement (P = 0.01), lesser positive lymph nodes (P = 0.02), and high preoperative HGB (P = 0.01). Further, high postoperative FBG patients displayed a significantly better DFS than low postoperative FBG patients (48.80 ± 22.12 months vs. 40.06 ± 24.36 months, P = 0.04), but it was less likely to be an independent prognostic factor. Conclusions Postoperative FBG plays a temporal prognostic role for patients with stage I-III CRC with a prior normal FBG, but it is not an independent prognostic factor.
Highlights
The relationship between blood glucose metabolism and cancer has been under extensive study for many years, for those diagnosed with type 2 diabetes mellitus (T2DM) [1]
In contrast, Cui et al conducted a study of 391 patients with colorectal cancer (CRC), including 116 patients with high fasting blood glucose (FBG), and found that FBG was linked to larger tumor diameters, lower tumor differentiation, advanced TNM stage, and a more ulcerative type but had no influence on distant metastasis or overall survival (OS) [11]
We aimed to explore the prognostic role of postoperative FBG and other clinicopathological features, including the abovementioned body mass index (BMI) and neutrophil-lymphocyte ratio (NLR), in stage I-III CRC patients with a prior normal FBG
Summary
The relationship between blood glucose metabolism and cancer has been under extensive study for many years, for those diagnosed with type 2 diabetes mellitus (T2DM) [1]. The high morbidity of malignancies in individuals with long-term aberrant fasting blood glucose (FBG) or T2DM has been established [2, 3], and examples have been provided in breast cancer [3], esophageal cancer [4], liver cancer [5], and colorectal cancer (CRC) [3, 6], which is one of the leading causes of cancer-related death in China [7]. Contiero et al reported a study that included 1,261 stage I-III breast cancer patients and found that high FBG correlated with distant metastasis or recurrence and death [9]. Studies concerning the role of FBG in CRC patients treated with curable resection, in those with a prior normal FBG, have not been reported
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