4 years ago

Glycemic Status and Prognosis of Patients with Squamous Cell Carcinoma of the Esophagus

Takanori Kurogochi, Yu Imamura, Masaru Hayami, Akihiko Okamura, Shinji Mine, Kotaro Yamashita, Masayuki Watanabe



The impact of glycemic status on esophageal squamous cell carcinoma (ESCC) prognosis is unclear.


A total of 623 patients who underwent curative subtotal esophagectomy for ESCC were evaluated. Diabetes was defined as a prior diagnosis of diabetes under treatment or newly diagnosed diabetes based on preoperative glycosylated hemoglobin (HbA1c) levels. Poor glycemic control was defined as HbA1c ≥ 7.0%, whereas good glycemic control was defined as HbA1c < 7.0%. The impact of glycemic status on long-term survival after esophagectomy was evaluated.


Among the 623 patients, 64 (10.3%) had diabetes including 30 (4.8%) with poor glycemic control. Although diabetes did not influence patient survival, patients with poor glycemic control had worse overall and disease-specific survival compared with those with good glycemic control (P = 0.011 and 0.039, respectively). Comparing poor glycemic control with good glycemic control, the hazard ratios (HRs) for overall and disease-specific mortality were 1.91 (1.15–3.18) and 1.89 (1.02–3.49) in univariate analysis. After multivariate adjustment, poor glycemic control also had increased risk of overall and disease-specific mortality [HR 1.72 (95% CI 1.02–2.88) and 1.65 (95% CI 0.89–3.08), respectively]. Poor glycemic control did not increase the risk of overall or disease-specific mortality in patients with stages 0–II disease but significantly increased this risk in those with stages III–IV disease [HR 2.05 (1.14–3.69) and 1.95 (1.01–3.80), respectively].


Poor glycemic control is an independent risk factor for overall and disease-specific mortality after esophagectomy for advanced-stage ESCC.

Publisher URL: https://link.springer.com/article/10.1007/s00268-017-4036-1

DOI: 10.1007/s00268-017-4036-1

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