Abstract 1173P
Background
Hyperglycaemia has been indicated as a pro-tumoral factor; however, the prognostic role of diabetes mellitus (DM) in pancreatic neuroendocrine neoplasms (panNENs) remains ambiguous, partly due to the effects of anti-diabetic drugs. We hypothesize that the blood sugar level per se affects the outcome of panNENs, and thus, we investigated the prognostic significance of the fasting blood glucose (FBG) level in non-diabetic resected panNEN patients.
Methods
A retrospective cohort study comprising 242 resected panNEN patients was conducted. A total of 193 patients without pre-existing DM were further studied. An FBG level greater than 5.6 mmol/L was defined as high (otherwise, normal). Survival was evaluated using Kaplan-Meier methods and log-rank tests. Multivariate analyses for survival were performed using the Cox regression model. A logistic regression model was used to assess FBG levels and the risk of nodal metastasis.
Results
High FBG levels were significantly associated with poor overall survival (OS; p = 0.001) and recurrence-free survival (RFS; p = 0.021) in non-diabetic resected panNEN patients. The multivariable-adjusted hazard ratios (HRs) for mortality and recurrence comparing patients with high and normal FBG levels were 4.84 (95% confidence interval (CI)=1.34 to 17.46, p = 0.016) and 1.82 (95% CI=1.01 to 3.29, p = 0.048), respectively. High FBG levels were also independently correlated with nodal metastasis (adjusted odds ratio (OR): 2.33, 95% CI: 1.04 to 5.20, p = 0.039).
Conclusions
A pre-operative FBG level greater than 5.6 mmol/L is associated with poor OS and RFS and a high risk of nodal metastasis for non-diabetic panNEN patients who undergo surgical resection.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The author.
Funding
Has not received any funding.
Disclosure
The author has declared no conflicts of interest.