Abstract
PurposeThe long-term prognostic impact of the hemoglobin A1c levels has not yet been evaluated in patients with gastric cancer. The present study investigated the clinical significance of the hemoglobin A1c levels in patients with gastric cancer.MethodsWe enrolled 294 patients with stage II, III, or IV gastric cancer who underwent gastrectomy. The patients were divided into high preoperative hemoglobin A1c (> 6.0%) and low preoperative hemoglobin A1c (≤ 6.0%) groups.ResultsIn patients with stage III gastric cancer with severe postoperative complications, the high preoperative hemoglobin A1c group had a significantly worse prognosis than the low preoperative hemoglobin A1c group (p = 0.0409). In patients without severe postoperative complications, the high preoperative hemoglobin A1c group had a significantly favorable prognosis compared with the low preoperative hemoglobin A1c group (p = 0.0348).ConclusionThe prognosis of patients with stage III gastric cancer having high preoperative hemoglobin A1c levels greatly depended on the presence or absence of postoperative complications. To avoid postoperative complications, optimal perioperative management and personalized treatments are critical, particularly for these patients.
Highlights
Gastric cancer (GC) is the fifth-most frequently occurring malignancy, and it is the third-leading cause of cancerrelated deaths worldwide [1]
We investigated the correlation between the preoperative Hemoglobin A1c (HbA1c) levels and postoperative clinical outcomes including the prognosis according to pathological stage
Curative gastrectomy (R0) was performed for 245 patients with stage II and III GC, whereas palliative gastrectomy was performed for 49 patients with stage IV GC
Summary
Gastric cancer (GC) is the fifth-most frequently occurring malignancy, and it is the third-leading cause of cancerrelated deaths worldwide [1]. Despite advances in surgical techniques, postoperative management, and treatment strategies, the long-term prognosis has not significantly improved, which remains a major challenge to human health [2]. In the past several decades, the increased incidence of lifestyle-related diseases, such as diabetes mellitus (DM), cardiovascular disease (CVD), and hyperlipidemia, has made postoperative health care more challenging and complicated. DM or poor postoperative glycemic control is reported to be a risk factor for short-term postoperative complications in patients with cancer [5, 13], the longterm prognostic impact of hyperglycemia or hypoglycemia. The long-term prognostic impact of the HbA1c levels has not yet been evaluated in patients with GC
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