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J.W. Suh



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    P3.16 - Surgery (ID 732)

    • Event: WCLC 2017
    • Type: Poster Session with Presenters Present
    • Track: Surgery
    • Presentations: 1
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      P3.16-019 - Prognostic Factors for Resected Non-Small Cell Lung Cancer in Patients with Type 2 Diabetes Mellitus (ID 8534)

      09:30 - 09:30  |  Author(s): J.W. Suh

      • Abstract

      Background:
      For diabetic patients with lung cancer, blood glucose levels and medications such as metformin and statins may impact survival. This retrospective study defined prognostic survival factors for diabetic patients with resected non-small cell lung cancer.

      Method:
      Between January 2005 and December 2013, 301 patients with type 2 diabetes mellitus who underwent curative resection for non-small cell lung cancer were identified and reviewed retrospectively. Prognostic factors for lung cancer–specific and overall survival were evaluated using the Cox proportional hazards regression model.

      Result:
      The median follow-up period was 48 months (interquartile range, 30–72). In a multivariate analysis for lung cancer–specific survival, older age, forced expiratory volume in 1 second (FEV1) < 80 % predicted, and advanced pathologic stage were significant negative prognostic factors; statin use was a positive prognostic factor [hazard ratio, 0.468; 95% confidential interval, 0.258–0.849]. In a multivariate analysis for overall survival, male sex, older age, FEV1 < 80 % predicted, and advanced pathologic stage were significant negative prognostic factors; proper glycemic control (hazard ratio, 0.645; 95% confidence interval, 0.436–0.952) and statin use (hazard ratio, 0.602; 95% confidence interval, 0.390–0.931) were positive prognostic factors.

      Prognostic factors related to overall survival
      Variable Univariate HR (95% CI) Multivariate HR (95% CI)
      Male 2.682 (1.603–4.486) 2.628 (1.287–5.366)
      Age 1.041 (1.016–1.066) 1.070 (1.042–1.099)
      Smoking 1.927 (1.247–2.979) 0.988 (0.527–1.850)
      FEV1% predicted <80 1.843 (1.254–2.708) 1.647 (1.073–2.530)
      Obesity (BMI ≥25) 0.573 (0.387–0.848) 0.752 (0.496–1.138)
      Proper glucose control 0.700 (0.487–1.006) 0.645 (0.436–0.952)
      Cardiovascular comorbidity 1.315 (0.896–1.929)
      Neoplastic comorbidity 1.259 (0.815–1.946)
      Renal insufficiency 1.338 (0.871–2.055)
      Metformin 1.131 (0.781–1.638)
      Insulin 1.465 (0.886–2.422)
      Statin 0.602 (0.398–0.911) 0.602 (0.390–0.931)
      Non-adenocarcinoma 1.724 (1.203–2.470 0.905 (0.571–1.435)
      Pneumonectomy 2.386 (1.364–4.175) 1.520 (0.806–2.864)
      R1 (vs R0) 1.841 (0.452–7.492)
      Stage
      I Reference
      II 2.594 (1.694–3.973) 3.315 (1.837–5.983)
      III/IV 3.818 (2.445–5.961) 6.515 (3.471–12.226)
      Adjuvant treatment 1.545 (1.076–2.217) 0.606 (0.361–1.018)


      Conclusion:
      Proper glycemic control (HbA1C <7.0) is recommended for diabetic patients undergoing lung cancer surgery. Statin use was associated with improved overall survival and lung cancer–specific survival. Further studies are required to elucidate associations between type 2 diabetes mellitus and anti-neoplastic effects of statins and to evaluate statins as a novel adjuvant treatment for lung cancer.