Prognostic significance of body mass index and diabetes in patients with malignant glioma

Year 2020, , 269 - 274, 01.06.2020

Berrin Benli Yavuz , Gül Kanyılmaz , Meryem Aktan

https://doi.org/10.21601/ortadogutipdergisi.709170

Abstract

Aim: We aimed to determine whether there is a relationship between body mass index (BMI) and diabetes (DM) before treatment and survival with this study.

Material and Methods: The results of patients who received radiotherapy between 2010 - 2018 were evaluated with this retrospective study. BMI was categorized into 3 groups: normal (18.5-24.9 kg/m2), overweight (25-29.9 kg/m2), obese (≥30 kg/m2). Presence of diabetes was evaluated by considering oral antidiabetic use and file information before treatment. Patient, treatment and tumor characteristics were evaluated with descriptive statistics. Kaplan-Meirer, log-rank and cox-regression analyzes were performed. P <0.05 was considered statistically significant.

Results: The results of 174 cases were evaluated. Diabetes was present in 22 patients (12.6%). In univariate analyzes, being over the age of 65 (p <0.001), Karnofsky performance score (KPS) below 80 (p <0.001), diabetes (p = 0.017), having grad 4 pathology (p <0.001), performing subtotal excision / biopsy (p <0.001), hypofractioned / whole brain radiotherapy (p <0.001), and not receiving adjuvant chemotherapy (CT) (p <0.001) had a negative effect on overall survival (OS). In multivariate analyzes, being over 65 years old, having grad 4 pathology, performing subtotal excision / biopsy and not taking adjuvant CT were found to be effective on OS. Median overall survival in diabetics was 9.65 months and 17.74 months in non-diabetics (p = 0.017). No statistically significant relationship was found between BMI and OS.

Conclusion: Pre-existing diabetes in malignant glioma patients is a risk factor for poor outcomes. It is important to control diabetes and related conditions.

Keywords

malign glioma, diabetes, body mass index, prognosis

Malign gliom hastalarında vücut kitle indeksi ve diabetin prognostik önemi

Abstract

Amaç: Bu çalışma ile tedavi öncesi vücut kitle indeksi (VKI) ve diyabet ile sağ kalım arasında bir ilişki olup olmadığını belirlemeyi amaçladık.

Gereç ve Yöntemler: Bu retrospektif çalışma ile 2010-2018 tarihleri arasında radyoterapi (RT) uygulanmış hastaların sonuçları değerlendirildi. VKI, 3 gruba kategorize edildi: normal (18,5-24,9 kg/m²), aşırı kilolu (25-29,9 kg/m²), obez (≥30 kg/m²). Diyabet varlığı, hastaların tedavi öncesi oral antidiyabetik kulanımı ve dosya bilgileri göz önüne alınarak değerlendirildi. Hasta, tedavi ve tümör karakteristikleri tanımlayıcı istatistikler ile değerlendirildi. Kaplan-Meirer, log-rank ve çoklu analizlerde cox-regresyon analizleri yapıldı. P<0,05 istatistiki anlamlı olarak kabul edildi.

Bulgular: 174 olgunun sonuçları değerlendirildi. Diyabet hastaların 22’sinde (%12,6) mevcuttu. Tek değişkenli analizlerde, 65 yaş üstünde olmak (p<0,001), Karnofsky performans skorunun (KPS) 80’in altında olması (p<0,001), diyabet olması (p=0,017), grad 4 patolojiye sahip olmak (p<0,001), subtotal eksizyon/biopsi yapılması (p<0,001), hipofraksiyone/tüm beyin radyoterapisi uygulanması (p<0,001) ve adjuvan kemoterapi (KT) almamak (p<0,001) genel sağ kalım üzerinde olumsuz etkili idi. Çok değişkenli analizlerde ise, 65 yaş üstü olmak, grad 4 patolojiye sahip olmak, subtotal eksizyon/biopsi yapılması ve adjuvan KT almamak genel sağ kalım (GS) üzerine etkili olarak bulundu. Diyabetiklerde medyan genel sağkalım 9,65 ay iken diyabetik olmayanlarda 17,74 ay idi (p=0,017). VKI ile GS arasında istatistiki anlamlı bir ilişki gösterilemedi.

Sonuç: Önceden var olan diyabet kötü sonuçlar açısından bir risk faktörüdür. Diyabet ve ilişkili durumların kontrol altında olması önemlidir.

Keywords

malign glioma, diyabet, vücut kitle indeksi, prognoz

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