Impact of diabetes and hyperglycemia on survival in advanced breast cancer patients.
OBJECTIVE
We examined the impact of diabetes and hyperglycemia on cancer-specific survival of patients with metastatic or recurrent breast cancer (BC).


METHODS
We performed a retrospective analysis of 265 patients with advanced BC receiving palliative chemotherapy. BC-specific mortality was compared for diabetic and nondiabetic patients as well as for patients that presented hyperglycemia during treatment.


RESULTS
No difference was observed between the diabetic and nondiabetic patients in terms of overall survival (OS). A difference in OS was observed between nondiabetic patients and diabetic patients who had hyperglycemia. The OS was greater in diabetic patients with proper metabolic control than diabetic patients with hyperglycemia. The risk of death was higher in patients with mean glucose levels >130 mg/dL during treatment. Several factors were associated with poor OS: tumor stage, hormone-receptor-negative tumors, HER2 negative disease, multiple metastatic sites, presence of visceral metastases, and mean glucose >130 mg/dL.


CONCLUSIONS
Elevated glucose levels are associated with a poor outcome in diabetic and nondiabetic patients in contrast to patients with normoglycemic levels, conferring an elevated risk of death. According to these results, clinicians should monitor glucose levels during treatment for advanced breast cancer disease and take action to maintain normal glucose levels.
Clínica de Cáncer de Mama, Instituto Nacional de Cancerología, 14080 México, DF, Mexico.
Cynthia
C
Villarreal-Garza
Robin
R
Shaw-Dulin
Fernando
F
Lara-Medina
Ludwing
L
Bacon
Daniel
D
Rivera
Lorena
L
Urzua
Christian
C
Aguila
Rebeca
R
Ramirez-Morales
Julieta
J
Santamaria
Enrique
E
Bargallo
Alejandro
A
Mohar
Luis A
LA
Herrera
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism* / Q000401:mortality*; D015331:Cohort Studies; D048909:Diabetes Complications / Q000378:metabolism / Q000401:mortality; D003920:Diabetes Mellitus / Q000378:metabolism* / Q000401:mortality; D004358:Drug Therapy / Q000379:methods; D005260:Female; D006801:Humans; D006943:Hyperglycemia / Q000150:complications / Q000378:metabolism* / Q000401:mortality; D008875:Middle Aged; D009362:Neoplasm Metastasis; D010166:Palliative Care / Q000379:methods; D012189:Retrospective Studies; D012306:Risk; D016896:Treatment Outcome
D001786:Blood Glucose