Dataset Information

Pre-existing diabetes and lung cancer prognosis.

ABSTRACT:

Background

The aims of this study are to investigate the impact of pre-existing diabetes and diabetes treatments on lung cancer prognosis.

Methods

A total of 2484 women with confirmed incident lung cancer from the Women's Health Initiative were followed for an average of 2.9 years through the date of death or 29 August 2014.

Results

Compared with women with lung cancer but without diabetes, women with lung cancer and diabetes had significantly increased risk of overall mortality (HR=1.27, 95% CI: 1.07-1.50). Women with diabetes receiving insulin or metformin or women who had long duration of diabetes also had increased risk of overall mortality.

Conclusions

Our large prospective study provides evidence that pre-existing diabetes is associated with poor overall survival among women with lung cancer, but do not support the hypothesis that metformin use may have a protective effect in women with lung cancer and diabetes.

SUBMITTER: Luo J

PROVIDER: S-EPMC4931364 | biostudies-literature | 2016 Jun

REPOSITORIES: biostudies-literature

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Publications

Pre-existing diabetes and lung cancer prognosis.

Luo Juhua J Hendryx Michael M Qi Lihong L Ho Gloria Yf GY Margolis Karen L KL

British journal of cancer 20160519 1

<h4>Background</h4>The aims of this study are to investigate the impact of pre-existing diabetes and diabetes treatments on lung cancer prognosis.<h4>Methods</h4>A total of 2484 women with confirmed incident lung cancer from the Women's Health Initiative were followed for an average of 2.9 years through the date of death or 29 August 2014.<h4>Results</h4>Compared with women with lung cancer but without diabetes, women with lung cancer and diabetes had significantly increased risk of overall mort ...[more]

PMID: 27195423

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Project description:The impact of pre-existing diabetes mellitus (DM) on hepatocellular carcinoma (HCC) occurrence and prognosis is complex and unclear. The aim of this meta-analysis is to evaluate the association between pre-existing diabetes mellitus and hepatocellular carcinoma occurrence and prognosis.We searched PubMed, Embase and the Cochrane Library from their inception to January, 2011 for prospective epidemiological studies assessing the effect of pre-existing diabetes mellitus on hepatocellular carcinoma occurrence, mortality outcomes, cancer recurrence, and treatment-related complications. Study-specific risk estimates were combined by using fixed effect or random effect models.The database search generated a total of 28 prospective studies that met the inclusion criteria. Among these studies, 14 reported the risk of HCC incidence and 6 studies reported risk of HCC specific mortality. Six studies provided a total of 8 results for all-cause mortality in HCC patients. Four studies documented HCC recurrence risks and 2 studies reported risks for hepatic decomposition occurrence in HCC patients. Meta-analysis indicated that pre-existing diabetes mellitus (DM) was significantly associated with increased risk of HCC incidence [meta-relative risk (RR)?=?1.87, 95% confidence interval (CI): 1.15-2.27] and HCC-specific mortality (meta-RR?=?1.88, 95%CI: 1.39-2.55) compared with their non-DM counterparts. HCC patients with pre-existing DM had a 38% increased (95% CI: 1.13-1.48) risk of death from all-causes and 91% increased (95%CI: 1.41-2.57) risk of hepatic decomposition occurrence compared to those without DM. In DM patients, the meta-RR for HCC recurrence-free survival was 1.93(95%CI: 1.12-3.33) compared with non-diabetic patients.The findings from the current meta-analysis suggest that DM may be both associated with elevated risks of both HCC incidence and mortality. Furthermore, HCC patients with pre-existing diabetes have a poorer prognosis relative to their non-diabetic counterparts.

Project description:BACKGROUND:Baseline cardiovascular disease (CVD) can impact the patterns of treatment and hence the outcomes of patients with lung cancer. This study aimed to characterize treatment trends and survival outcomes of patients with pre-existing CVD prior to their diagnosis of lung cancer. METHODS:We conducted a retrospective, population-based cohort study of patients with lung cancer diagnosed from 2004 to 2015 in a large Canadian province. Multivariable logistic regression and Cox regression models were constructed to determine the associations between CVD and treatment patterns, and its impact on overall (OS) and cancer-specific survival (CSS), respectively. A competing risk multistate model was developed to determine the excess mortality risk of patients with pre-existing CVD. RESULTS:A total of 20,689 patients with lung cancer were eligible for the current analysis. Men comprised 55%, and the median age at diagnosis was 70?years. One-third had at least one CVD, with the most common being congestive heart failure in 15% of patients. Pre-existing CVD was associated with a lower likelihood of receiving chemotherapy (odds ratio [OR], 0.53; 95% confidence interval [CI], 0.48-0.58; P?<?.0001), radiotherapy (OR, 0.76; 95% CI, 0.7-0.82; P?<?.0001), and surgery (OR, 0.56; 95% CI, 0.44-0.7; P?<?.0001). Adjusting for measured confounders, the presence of pre-existing CVD predicted for inferior OS (hazard ratio [HR], 1.1; 95% CI, 1.1-1.2; P?<?.0001) and CSS (HR, 1.1; 95% CI, 1.1-1.1; P?<?.0001). However, in the competing risk multistate model that adjusted for baseline characteristics, prior CVD was associated with increased risk of non-cancer related death (HR, 1.48; 95% CI, 1.33-1.64; P?<?0.0001) but not cancer related death (HR, 0.98; 95% CI, 0.94-1.03; P?=?0.460). CONCLUSIONS:Patients with lung cancer and pre-existing CVD are less likely to receive any modality of cancer treatment and are at a higher risk of non-cancer related deaths. As effective therapies such as immuno-oncology drugs are introduced, early cardio-oncology consultation may optimize management of lung cancer.

Dataset Information

Pre-existing diabetes and lung cancer prognosis.

Background

Methods

Results

Conclusions

Publications

Pre-existing diabetes and lung cancer prognosis.

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