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The association between fasting blood glucose and prognosis in gastrointestinal stromal tumor patients after curable resection

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Abstract

Blood glucose has been demonstrated to serve as prognostic indicators in various malignancies. This study aimed to explore the relationship between fasting blood glucose (FBG) levels and the prognosis in patients with gastrointestinal stromal tumor (GIST) undergoing complete resection. Data were retrospectively collected from 256 patients with primary GIST underwent complete surgical resection or endoscopic excision. Patients were stratified into euglycemic group and hyperglycemic group. Patients’ characteristics between groups were compared. Cox regression model was conducted to identify independent prognostic factors of disease-free survival (DFS). Both univariate analysis and multivariate analyses revealed that FBG ≥ 100 mg/dl was associated with poor outcomes. Patients with FBG ≥ 100 mg/dl tended to have more adverse features, more likely to suffer recurrence and a worse 5-year DFS than patients with FBG < 100 mg/dl. Moreover, FBG levels helped distinguishing between patients with different survival outcomes in different risk categories defined by modified NIH systems. Our data provided the evidence that FBG is a useful prediction marker prognosis in patients with GIST undergoing curative surgery.

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Data availability

The data included in this study are available from the corresponding author if reasonable request.

References

  1. Casali PG, Abecassis N, Bauer S, Biagini R, Bielack S, Bonvalot S et al (2018) Gastrointestinal stromal tumours: ESMO-EURACAN clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol 29(Suppl 4):iv68–iv78

    Article  CAS  PubMed  Google Scholar 

  2. Choi AH, Hamner JB, Merchant SJ, Trisal V, Chow W, Garberoglio CA et al (2015) Underreporting of gastrointestinal stromal tumors: is the true incidence being captured? J Gastrointest Surg 19:1699–1703

    Article  PubMed  Google Scholar 

  3. DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF et al (2000) Two hundred gastrointestinal stromal tumors: Recurrence patterns and prognostic factors for survival. Ann Surg 231:51–58

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  4. Joensuu H, Vehtari A, Riihimaki J, Nishida T, Steigen SE, Brabec P et al (2012) Risk of recurrence of gastrointestinal stromal tumour after surgery: an analysis of pooled population-based cohorts. Lancet Oncol 13:265–274

    Article  PubMed  Google Scholar 

  5. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ et al (2002) Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 33:459–465

    Article  PubMed  Google Scholar 

  6. Joensuu H (2008) Risk stratification of patients diagnosed with gastrointestinal stromal tumor. Hum Pathol 39:1411–1419

    Article  PubMed  Google Scholar 

  7. Wada N, Kurokawa Y, Nishida T, Takahashi T, Toyokawa T, Kusanagi H et al (2014) Subgroups of patients with very large gastrointestinal stromal tumors with distinct prognoses: a multicenter study. J Surg Oncol 109:67–70

    Article  PubMed  Google Scholar 

  8. Sheng L, Peng H, Pan Y, Wang C, Zhu Y (2020) Evaluating the effect of diabetes on the prognosis of gastric cancer using a propensity score matching method. J Gastrointest Oncol 11:999–1008

    Article  PubMed  PubMed Central  Google Scholar 

  9. Vulcan A, Manjer J, Ohlsson B (2017) High blood glucose levels are associated with higher risk of colon cancer in men: a cohort study. BMC Cancer 17:842

    Article  PubMed  PubMed Central  Google Scholar 

  10. Smolle E, Leko P, Stacher-Priehse E, Brcic L, El-Heliebi A, Hofmann L et al (2020) Distribution and prognostic significance of gluconeogenesis and glycolysis in lung cancer. Mol Oncol 14:2853–2867

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Contiero P, Berrino F, Tagliabue G, Mastroianni A, Di Mauro MG, Fabiano S et al (2013) Fasting blood glucose and long-term prognosis of non-metastatic breast cancer: a cohort study. Breast Cancer Res Treat 138:951–959

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Iarrobino NA, Gill BS, Klement RJ, Bernard ME, Champ CE (2019) The impact of serum glucose in the treatment of locoregionally advanced pancreatic cancer. Am J Clin Oncol 42:692–697

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Genuth S, Alberti KG, Bennett P, Buse J, Defronzo R, Kahn R et al (2003) Follow-up report on the diagnosis of diabetes mellitus. Diabetes Care 26:3160–3167

    Article  PubMed  Google Scholar 

  14. Miettinen M, Lasota J (2006) Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol 23:70–83

    Article  PubMed  Google Scholar 

  15. Tsai MC, Lin JW, Lin SE, Chen HH, Lee CM, Hu TH (2008) Prognostic analysis of rectal stromal tumors by reference of National Institutes of Health risk categories and immunohistochemical studies. Dis Colon Rectum 51:1535–1543

    Article  PubMed  Google Scholar 

  16. Huang HY, Li CF, Huang WW, Hu TH, Lin CN, Uen YH et al (2007) A modification of NIH consensus criteria to better distinguish the highly lethal subset of primary localized gastrointestinal stromal tumors: a subdivision of the original high-risk group on the basis of outcome. Surgery 141:748–756

    Article  PubMed  Google Scholar 

  17. Richardson LC, Pollack LA (2005) Therapy insight: Influence of type 2 diabetes on the development, treatment and outcomes of cancer. Nat Clin Pract Oncol 2:48–53

    Article  PubMed  Google Scholar 

  18. Wang X, Wang H, Zhang T, Cai L, Dai E, He J (2020) Diabetes and its Potential Impact on Head and Neck Oncogenesis. J Cancer 11:583–591

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Fiorillo C, Rosa F, Quero G, Menghi R, Doglietto GB, Alfieri S (2017) Postoperative hyperglycemia in nondiabetic patients after gastric surgery for cancer: perioperative outcomes. Gastric Cancer 20:536–542

    Article  CAS  PubMed  Google Scholar 

  20. Villarreal-Garza C, Shaw-Dulin R, Lara-Medina F, Bacon L, Rivera D, Urzua L et al (2012) Impact of diabetes and hyperglycemia on survival in advanced breast cancer patients. Exp Diabetes Res 2012:732027–732028

    Article  PubMed  PubMed Central  Google Scholar 

  21. Supabphol S, Seubwai W, Wongkham S, Saengboonmee C (2021) High glucose: an emerging association between diabetes mellitus and cancer progression. J Mol Med 99:1175–1193

    Article  CAS  PubMed  Google Scholar 

  22. Gerards MC, van der Velden DL, Baars JW, Brandjes DPM, Hoekstra JBL, Vriesendorp TM et al (2017) Impact of hyperglycemia on the efficacy of chemotherapy-a systematic review of preclinical studies. Crit Rev Oncol Hematol 113:235–241

    Article  PubMed  Google Scholar 

  23. Varghese S, Samuel SM, Varghese E, Kubatka P, Büsselberg D (2019) High glucose represses the anti-proliferative and proapoptotic effect of metformin in triple negative breast cancer cells. Biomolecules 9:16

    Article  PubMed  PubMed Central  Google Scholar 

  24. Kontzoglou K, Palla V, Karaolanis G, Karaiskos I, Alexiou I, Pateras I et al (2013) Correlation between Ki67 and breast cancer prognosis. Oncology 84:219–225

    Article  CAS  PubMed  Google Scholar 

  25. Pathmanathan N, Balleine RL (2013) Ki67 and proliferation in breast cancer. J Clin Pathol 66:512–516

    Article  CAS  PubMed  Google Scholar 

  26. Koumarianou A, Chatzellis E, Boutzios G, Tsavaris N, Kaltsas G (2013) Current concepts in the diagnosis and management of poorly differentiated gastrointestinal neuroendocrine carcinomas. Endokrynol Pol 64:60–72

    PubMed  Google Scholar 

  27. Segales-Rojas P, Lino-Silva LS, Aguilar-Cruz E, Salcedo-Hernández RA (2018) Association of ki67 Index with Recurrence in Gastrointestinal Stromal Tumors. J Gastrointest Cancer 49:543–547

    Article  PubMed  Google Scholar 

  28. Turkel Kucukmetin N, Cicek B, Saruc M, Ersoy O, Vardareli E, Onder O et al (2015) Ki67 as a prognostic factor for long-term outcome following surgery in gastrointestinal stromal tumors. Eur J Gastroenterol Hepatol 27:1276–1280

    Article  CAS  PubMed  Google Scholar 

  29. Ottaiano A, De Divitiis C, Capozzi M, Avallone A, Pisano C, Pignata S et al (2018) Obesity and Cancer: biological Links and Treatment Implications. Curr Cancer Drug Targets 18:231–238

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We gratefully thank Hui Tang for her excellent working on communication with patients.

Funding

This work was supported by Guangdong Medical Research Foundation (A2019483) and Natural Science Foundation of Guangdong Province of China (2019A1515011723).

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Authors and Affiliations

  1. Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, GD510655, People’s Republic of China

    Yi Liao, Jintuan Huang, Hao Chen, Senmao Li, Chunyu Chen, Feng Lin & Zuli Yang

  2. Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-Sen University, Guangzhou, GD510655, People’s Republic of China

    Yi Liao, Jintuan Huang, Hao Chen, Senmao Li, Chunyu Chen, Feng Lin & Zuli Yang

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  1. Yi Liao
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Contributions

Y.Z. and L.Y. performed the study design and wrote the manuscript of the paper. L.Y. and H.J. collected the data. Y.Z., L.Y., H.J., C.H., L.S., C.C and L.F. performed the statistical analysis. All the authors reviewed the paper.

Corresponding author

Correspondence to Zuli Yang.

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Conflict of interests

The authors declare no competing interest.

Ethics approval and Consent to participate

The study was approved by the by the Ethics Committee of Sun Yat-sen University and performed in accordance with the Declaration of Helsinki. Written informed consent was obtained from all patients included in this study.

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Liao, Y., Huang, J., Chen, H. et al. The association between fasting blood glucose and prognosis in gastrointestinal stromal tumor patients after curable resection. Updates Surg 75, 1219–1226 (2023). https://doi.org/10.1007/s13304-023-01500-z

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  • DOI: https://doi.org/10.1007/s13304-023-01500-z

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