Abstract
BackgroundFasting blood glucose and glycated hemoglobin (HbA1c) levels are associated with the risk of pancreatic cancer.AimTo examine the relationship between perioperative glucose and HbA1c levels and prognosis in patients with pancreatic cancer.MethodsPubMed, Embase, and the Cochrane Library were queried for potentially eligible studies published up to May 2021. The exposures were perioperative fasting glucose and HbA1c levels. The primary outcome was survival. The secondary outcome was complications. All analyses were performed using the random-effects model.ResultsTen studies (48,424 patients) were included. The pre-operative (HR=1.10, 95%CI: 0.89-1.35; I2 = 45.1%, Pheterogeneity=0.078) and postoperative (HR=1.19, 95%CI: 0.92-1.54; I2 = 67.9%, Pheterogeneity=0.001) blood glucose levels were not associated with the survival to pancreatic cancer. Similar results were observed for HbA1c (HR=1.09, 95%CI: 0.75-1.58; I2 = 64.2%, Pheterogeneity=0.039), fasting blood glucose (FBG)/HbA1c (HR=1.16, 95%CI: 0.67-1.68; I2 = 0.0%, Pheterogeneity=0.928), and FBG (HR=1.75, 95%CI: 0.81-3.75; I2 = 79.4%, Pheterogeneity=0.008). Pre-operative blood glucose levels were not associated with postoperative complications (OR=0.90, 95%CI: 0.52-1.56), but postoperative glucose levels were associated with postoperative complications (OR=3.06, 95%CI: 1.88-4.97; I2 = 0.0%, Pheterogeneity=0.619).ConclusionBlood glucose, FBG, and HbA1c levels are not associated with the survival of patients with pancreatic cancer. Postoperative blood glucose levels could predict postoperative complications.
Highlights
Pancreatic cancer has an age-standardized incidence of 5.5 per 100,000 men and 4 per 100,000 women [1, 2]
Similar results were observed for HbA1c (HR=1.09, 95% CI: 0.75-1.58; I2 = 64.2%, Pheterogeneity=0.039), fasting blood glucose (FBG)/HbA1c (HR=1.16, 95%CIs confidence interval (95%CI): 0.67-1.68; I2 = 0.0%, Pheterogeneity=0.928), and FBG (HR=1.75, 95% CI: 0.81-3.75; I2 = 79.4%, Pheterogeneity=0.008)
Pre-operative blood glucose levels were not associated with postoperative complications (OR=0.90, 95%CI: 0.52-1.56), but postoperative glucose levels were associated with postoperative complications (OR=3.06, 95%CI: 1.88-4.97; I2 = 0.0%, Pheterogeneity=0.619)
Summary
Pancreatic cancer has an age-standardized incidence of 5.5 per 100,000 men (ranks tenth worldwide) and 4 per 100,000 women (ranks ninth) [1, 2]. It is the ninth most common cause of cancer death worldwide (432,242 deaths in 2018) [1, 2] and, because it is usually diagnosed in its late stages, one of the most fatal cancers with a 5-year survival rate of
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