Impact of Diabetes Mellitus on the Prognosis of Patients with Oral Squamous Cell Carcinoma: A Retrospective Cohort Study
Impact of Diabetes Mellitus on the Prognosis of Patients with Oral Squamous Cell Carcinoma: A Retrospective Cohort Study
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DOI：
10.1245/s10434-010-0996-1
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发表时间：
2010-08-01
影响因子：
3.7
通讯作者：
Kao, Shou-Yen
中科院分区：
文献类型：
--
作者：
Wu, Cheng-Hsien;Wu, Tzu-Ying;Kao, Shou-Yen
糖尿病（DM）是一种常见的慢性代谢性疾病，据报道会影响恶性肿瘤的治疗结果。本研究探讨糖尿病对口腔鳞状细胞癌（OSCC）预后的影响。本研究将2002年至2005年在台北退伍军人总医院接受手术治疗的OSCC患者的临床病理特征及总生存期（OS）、无复发生存期（RFS）及肿瘤特异性生存期（CSS）进行分层比较。与非糖尿病患者相比，糖尿病患者的OS、RFS和CSS往往更低（校正风险比[HR]分别= 2.22、2.42和2.16），即使在肿瘤侵袭性较低的阶段（I期和II期）。在晚期肿瘤中，未给予辅助治疗的糖尿病患者复发率明显高于非糖尿病患者（HR = 2.66）。然而，可接受辅助治疗的局部晚期肿瘤患者的治疗结果无显著差异，即使DM组延迟开始辅助治疗（49.1 +/- A 22.3天vs. 40.0 +/- A 16.6天，P = 0.04）。DM还与较高的神经周围侵犯频率相关（校正优势比[OR] = 2.53）。糖尿病状态可能是OSCC的预后因素，特别是其对生存和神经周围侵袭的影响。虽然糖尿病相关的合并症可能会影响患者选择不那么积极的治疗方式，但辅助治疗对于提高糖尿病患者的生存率可能是必不可少的。
Diabetes mellitus (DM) is a prevalent chronic metabolic disease reported to affect the treatment outcomes of malignancies. This study explores the impact of diabetes on the prognosis of oral squamous cell carcinoma (OSCC).Clinicopathological characteristics and survival in terms of overall survival (OS), recurrence-free survival (RFS), and cancer-specific survival (CSS) of patients with OSCC who underwent surgical intervention at the Taipei Veterans General Hospital between 2002 and 2005 were stratified by diabetic status and compared.Patients with DM tend to have a lower OS, RFS, and CSS compared with nondiabetics (adjusted hazard ratio [HR] = 2.22, 2.42, and 2.16, respectively) even in less aggressive tumor stages (stage I and II). In advanced tumors, diabetic patients who were not prescribed adjuvant therapy had a significantly higher recurrence rate than nondiabetic patients (HR = 2.66). However, there was no significant difference in treatment outcome in patients with locally advanced tumors amenable to receive adjuvant therapy, even with the delayed initiation of adjuvant therapy in the DM group (49.1 +/- A 22.3 days vs. 40.0 +/- A 16.6 days, P = .04). DM was also associated with a higher frequency of perineural invasion (adjusted odds ratio [OR] = 2.53).DM status could be a prognostic factor for OSCC, particularly for its effect in the survival and perineural invasion. Although diabetes-associated comorbidities may impair decision making toward less aggressive therapeutic modality, adjuvant treatment may be essential for DM patients to improve their survival.