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Survival and glycemic control in patients with coexisting melanoma and diabetes mellitus.

ABSTRACT: Aim:Given the lack of data in the literature, we examined the impact of diabetes mellitus (DM) on melanoma survival and the impact of melanoma on glycemic control. Materials & methods:Patients with melanoma with and without DM were matched 1:1 (2005-2016). Kaplan-Meier analysis was used to estimate overall survival and progression-free survival (PFS). Mixed models compared hemoglobin A1c (HbA1c) and glucose measures over time. Results:Mean HbA1c during the year after cancer diagnosis was 6.7%. The 5-year PFS rate was 89% (95% CI: 81-99%) for patients with DM and 63% (95% CI: 51-79%) for patients without DM (p = 0.02). Conclusion:Melanoma did not adversely impact glycemic control. The DM did not adversely impact survival of patients with melanoma, although increased PFS for melanoma was seen in individuals with DM.

SUBMITTER: Karlin NJ

PROVIDER: S-EPMC6426167 | biostudies-literature | 2019 Mar

REPOSITORIES: biostudies-literature

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Survival and glycemic control in patients with coexisting melanoma and diabetes mellitus.

Karlin Nina J NJ Mangold Aaron R AR Amin Shailja B SB Kosiorek Heidi E HE Buras Matthew R MR Verona Patricia M PM Cook Curtiss B CB

Future science OA 20190307 3

<h4>Aim</h4>Given the lack of data in the literature, we examined the impact of diabetes mellitus (DM) on melanoma survival and the impact of melanoma on glycemic control.<h4>Materials & methods</h4>Patients with melanoma with and without DM were matched 1:1 (2005-2016). Kaplan-Meier analysis was used to estimate overall survival and progression-free survival (PFS). Mixed models compared hemoglobin A<sub>1c</sub> (HbA<sub>1c</sub>) and glucose measures over time.<h4>Results</h4>Mean HbA<sub>1c</ ...[more]

PMID: 30906566

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Project description:BackgroundDiabetes mellitus (DM) is a frequent comorbidity in patients with cancer. This study aimed to evaluate the prognosis of advanced non-small cell lung cancer (NSCLC) patients with DM and to assess whether an optimal glycemic control improves overall survival (OS).MethodsA total of 1279 advanced NSCLC patients including 300 (23.5%) with preexisting DM were retrospectively reviewed. The continuous relationship between glycated hemoglobin A1C (HbA1c) level and OS was analyzed by restricted cubic spline (RCS) function. Optimal HbA1c cut-off point was determined using X-tile analysis. Survival was analyzed with the Kaplan-Meier method and compared among groups stratified by diabetes status and HbA1c. Multivariable Cox proportional hazards regression analysis was employed to identify prognostic factors for OS after adjusting for baseline characteristics.ResultsDM and non-DM patients had similar OS (median (95% CI): 22.85 (20.05-26.73) vs. 22.22 (20.35-24.76) months, P=0.950). The multivariate Cox regression analyses showed that DM status was not a prognostic factor for OS (HR: 0.952, 95% CI: 0.808-1.122, P=0.559). However, there existed a non-linear but generally positive relationship between the elevated HbA1c level and increased risk of overall mortality. HbA1c > 6.6% was a negative prognostic factor for OS (HR: 1.593, 95% CI: 1.113-2.280, P=0.011). The median OS (95% CI) for nondiabetic patients, DM patients with HbA1c ≤6.6% and those with HbA1c > 6.6% was 22.22 (20.01-24.43), 25.28 (21.79-28.77) and 15.45 (7.57-23.33) months, respectively. Well-controlled DM patients had a comparable crude OS (HR (95% CI): 0.90 (0.76-1.08), P=0.273] compared to nondiabetic patients while patients with HbA1c>6.6% had a worse crude OS than patients without DM (HR (95% CI): 1.70 (1.24-2.34), P=0.001]. The survival benefit of good HbA1c control was prominent in all subgroups.ConclusionImpaired glycemic level negatively affects survival for patients with advanced NSCLC while proper glycemic control with HbA1c ≤6.6% improves the OS.

Dataset Information

Survival and glycemic control in patients with coexisting melanoma and diabetes mellitus.

Publications

Survival and glycemic control in patients with coexisting melanoma and diabetes mellitus.

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