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Type 2 diabetes mellitus and obesity are independent risk factors for poor outcome in patients with high-grade glioma

  • Clinical Study – Patient Study
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Abstract

Type 2 diabetes mellitus (DM) and obesity are known risk factors for poor outcomes in patients with systemic malignancies but are not well-studied in the brain tumor population. In this study we asked if type 2 DM and elevated body mass index (BMI) are independent risk factors for poor prognosis in patients with high-grade glioma (HGG.). We conducted a retrospective cohort study of 171 patients surgically treated for HGG at a single institution. BMI and records of pre-existing type 2 DM were obtained from medical histories. Variables associated with survival in a univariate analysis were included in the multivariate Cox model if P < 0.10. Variables with probability values >0.05 were then removed from the multivariate model in a step-wise fashion. Mean age at diagnosis was 55.0 ± 17.3 years. Fifteen (8.8%) patients had a history of type 2 DM. Fifty-eight (35.8%) patients had a BMI < 25, 55 (34.0%) BMI 25–30, and 49(30.2%) BMI > 30. Radiation therapy, temozolomide, and higher KPS score were independently associated with prolonged survival while increasing age was associated with decreased survival. DM (P = 0.001) and increasing BMI (P = 0.003) were found to be independently associated with decreased survival. Diabetics had a decreased median overall survival (312 vs. 470 days, P = 0.003) and PFS (106 vs. 166 days, P = 0.04) compared to non-diabetics. Increasing BMI (<25, 25–30, and >30) was also associated with decreased median PFS: 195 vs. 165 vs. 143 days, respectively. Pre-existing DM and elevated BMI are independent risk factors for poor outcome in patients with HGG.

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Acknowledgments

The authors wish to acknowledge Merry Beth Braswell, Aimee Cutrer, and Daniel Brill for their assistance in collection and maintenance of the clinical database used in this study and Kyle Weaver MD for his contribution of patients for analysis.

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Authors and Affiliations

  1. Department of Neurological Surgery, Vanderbilt University Medical Center, 1161 21 Avenue South, Nashville, TN, 37232-2380, USA

    Lola B. Chambless, Scott L. Parker, Laila Hassam-Malani, Matthew J. McGirt & Reid C. Thompson

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  1. Lola B. Chambless
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  2. Scott L. Parker
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  3. Laila Hassam-Malani
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  4. Matthew J. McGirt
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Correspondence to Lola B. Chambless.

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Chambless, L.B., Parker, S.L., Hassam-Malani, L. et al. Type 2 diabetes mellitus and obesity are independent risk factors for poor outcome in patients with high-grade glioma. J Neurooncol 106, 383–389 (2012). https://doi.org/10.1007/s11060-011-0676-4

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  • DOI: https://doi.org/10.1007/s11060-011-0676-4

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