European journal of medical research · 2025
Preoperative hyperglycemia as an independent predictor of reduced long-term survival after gastric cancer surgery.
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Lv Li, Chen Chunyu, Chen Hao, Huang Jintuan, Tam Wengcheong, Han Yuhang, Zhang Bowei, Liao Yi, Yang Zuli
Аннотация
OBJECTIVE: While hyperglycemia is known to influence long-term outcomes in various malignancies, this study specifically investigates its association with overall survival after gastric cancer surgery.
METHODS: This study included 1109 patients who underwent gastric cancer resection with curative intent at the Sixth Affiliated Hospital of Sun Yat-Sen University between January 2018 and December 2021. Patients were divided into hyperglycemia and non-hyperglycemia groups with preoperative fasting blood glucose (FBG) cut-off value of 126 mg/dL. Cox regression analysis and Kaplan-Meier survival curves were then employed to assess the relationship between hyperglycemia and overall survival (OS) in the entire cohort. Finally, a subgroup analysis was conducted to further explore these associations.
RESULTS: Among the 1109 patients, 121 (10.9%) were hyperglycemia and 988 (89.1%) were non-hyperglycemia. The 5-year overall survival rate was significantly lower in the hyperglycemia group compared to the non-hyperglycemia group (41.3% vs. 64.9%, P < 0.001). Kaplan-Meier survival curves indicated a significantly increased risk of mortality in hyperglycemia patients (log rank, P < 0.001). After adjustment, hyperglycemia remained independently associated with worse survival (adjusted Hazard Ratio: 1.74, 95% CI 1.31-2.32).
CONCLUSION: Preoperative hyperglycemia (FBG ≥ 126 mg/dL) is an independent risk factor for reduced long-term survival in gastric cancer patients, underscoring the critical importance of perioperative glycemic control as a key modifiable factor to improve surgical outcomes.
METHODS: This study included 1109 patients who underwent gastric cancer resection with curative intent at the Sixth Affiliated Hospital of Sun Yat-Sen University between January 2018 and December 2021. Patients were divided into hyperglycemia and non-hyperglycemia groups with preoperative fasting blood glucose (FBG) cut-off value of 126 mg/dL. Cox regression analysis and Kaplan-Meier survival curves were then employed to assess the relationship between hyperglycemia and overall survival (OS) in the entire cohort. Finally, a subgroup analysis was conducted to further explore these associations.
RESULTS: Among the 1109 patients, 121 (10.9%) were hyperglycemia and 988 (89.1%) were non-hyperglycemia. The 5-year overall survival rate was significantly lower in the hyperglycemia group compared to the non-hyperglycemia group (41.3% vs. 64.9%, P < 0.001). Kaplan-Meier survival curves indicated a significantly increased risk of mortality in hyperglycemia patients (log rank, P < 0.001). After adjustment, hyperglycemia remained independently associated with worse survival (adjusted Hazard Ratio: 1.74, 95% CI 1.31-2.32).
CONCLUSION: Preoperative hyperglycemia (FBG ≥ 126 mg/dL) is an independent risk factor for reduced long-term survival in gastric cancer patients, underscoring the critical importance of perioperative glycemic control as a key modifiable factor to improve surgical outcomes.