Araştırma Makalesi
BibTex RIS Kaynak Göster

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

Yıl 2020, , 269 - 274, 01.06.2020
https://doi.org/10.21601/ortadogutipdergisi.709170

Öz

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.

Kaynakça

  • Gondi V, Vogelbaum MA, Grimm S, Mehta MP Jr: Central Nervous System Tumors. Halperin EC, Wazer DE, Perez CA, Brady LW (eds). Principles and Practice of Radiation Oncology, 7th ed. Philadelphia: Wolters Kluwer; 2019: 799-837.
  • Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolamide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncology 2009; 10: 459-66. (doi: 10.1016/S1470-2045(09)70025-7).
  • Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC. Type 2 diabetes mellitus and obesity are independent risk factors for poor outcome in patients with high grade glioma. J Neurooncol 2012; 106: 383-9. (doi: 10.1007/s11060-011-0676-4).
  • He ZQ, Ke C, Al-Nahari F, et al. Low preoperative prognostic nutrional index predicts poor survival in patients with newly diagnosed high-grade gliomas. J Neurooncol 2017; 132: 239-47. (doi: 10.1007/s11060-016-2361-0).
  • Trestini I, Carbognin L, Bonaiuto C, Tortora G, Bria E. The obesity paradox in cancer: clinical insights and perspectives. Eat Weight Disord 2018; 23: 185-93. (doi: 10.1007/s40519-018-0489-y).
  • Alarcon S, Niechi I, Toledo F, Sobrevia L, Quezada C. Glioma progression in diabesity. Mol Aspect Med 2019; 66: 62-70. (doi: 10.1016/j.mam.2019.02.002).
  • Park Y, Colditz GA. Diabetes and adiposity: a heavy load for cancer. Lancet Diabetes Endocrinol 2017; 6: 82-3. (doi: 10.1016/S2213-8587(17)30396-0).
  • Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 2019; 157: 107843. (doi: 10.1016/j.diabres.2019.107843).
  • Barami K, Lyon L, Conell C. Type 2 diabetes mellitus and glioblastoma multiforme-assessing risk and survival: Results of a large retrospective study and systematic review of the literature. World Neurosurg 2017; 106: 300-7. (doi: 10.1016/j.wneu.2017.06.164).
  • Pearson-Stuttard J, Zhou B, Kontis V, Bentham J, Gunter MJ, Ezzati M. Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment. Lancet Diabetes Endocrinol 2018; 6: 95-104. (doi: 10.1016/S2213-8587(17)30366-2).
  • Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism 2019; 92: 6-10. (doi: 10.1016/j.metabol.2018.09.005).
  • Jones LW, Ali-Osman F, Lipp E, et al. Association between body mass index and mortality in patients with glioblastoma multiforme. Cancer Causes Control 2010; 21: 2195-201. (doi: 10.1007/s10552-010-9639-x).
  • Berger NA. Obesity and cancer pathogenesis. Ann N Y Acad Sci 2014; 1311: 57-76. (doi: 10.1111/nyas.12416).
  • Huang X, Shu C, Chen L, Yao B. Impact of sex, body mass index and initial pathologic diagnosis age on the incidence and prognosis of different types of cancer. Oncol Rep 2018; 40: 1359-69. (doi: 10.3892/or.2018.6529).
  • Wang Y, Sun Y, Tang J, Zhou W, et al. Does diabetes decrease the risk of glioma? A systematic review and meta-analysis of observational studies. Ann Epidemiol 2019; 30: 22-9. (doi: 10.1016/j.annepidem.2018.11.010).
  • Tong JJ, Tao h, Hui OT, Jian C. Diabetes mellitus and risk of brain tumours: A meta-analysis. Exp Ther Med 2012; 4: 877-82. (doi: 10.3892/etm.2012.698).
  • Lu VM, Goyal A, Vaughan LS, McDonald KL. The impact of hyperglycemia on survival in glioblastoma: A systematic review and meta-analysis. Clin Neurol Neurosurg 2018; 170: 165-9. (doi: 10.1016/j.clineuro.2018.05.020).
  • Yıldırım N. Obezite ve kanser. Firat Med J 2018; 23: 61-7. (doi: 10.16990/SOBIDER.4188).
  • Derr RL, Ye X, Islas MU, Desideri S, Saudek CD, Grossman SA. Association between hyperglicemia and survival in patients with newly diagnosed glioblastoma. J Clin Oncol 2009; 27: 1082-6. (doi: 10.1200/JCO.2008.19.1098).
  • Pohharaju M, Mangaleswaran B, Mathavan A, et al. Body mass index as a prognostic marker in glioblastome multiforme: A clinical outcomes. Int J Radiat Oncol Biol Phys 2018; 102: 204-9. (doi: 10.1016/j.ijrobp.2018.05.024).
  • Wiedmann MKH, Brunborg C, Di leva A, et al. Overweight, obesity and height as risk factors for menenjioma, glioma, pituitary adenoma and nevre sheath tumor: a large population-based prospective cohort study. Acta Oncol 2017; 56: 1302-9. (doi: 10.1080/0284186X.2017.1330554).

Malign gliom hastalarında vücut kitle indeksi ve diabetin prognostik önemi

Yıl 2020, , 269 - 274, 01.06.2020
https://doi.org/10.21601/ortadogutipdergisi.709170

Öz

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.

Kaynakça

  • Gondi V, Vogelbaum MA, Grimm S, Mehta MP Jr: Central Nervous System Tumors. Halperin EC, Wazer DE, Perez CA, Brady LW (eds). Principles and Practice of Radiation Oncology, 7th ed. Philadelphia: Wolters Kluwer; 2019: 799-837.
  • Stupp R, Hegi ME, Mason WP, et al. Effects of radiotherapy with concomitant and adjuvant temozolamide versus radiotherapy alone on survival in glioblastoma in a randomized phase III study: 5-year analysis of the EORTC-NCIC trial. Lancet Oncology 2009; 10: 459-66. (doi: 10.1016/S1470-2045(09)70025-7).
  • Chambless LB, Parker SL, Hassam-Malani L, McGirt MJ, Thompson RC. Type 2 diabetes mellitus and obesity are independent risk factors for poor outcome in patients with high grade glioma. J Neurooncol 2012; 106: 383-9. (doi: 10.1007/s11060-011-0676-4).
  • He ZQ, Ke C, Al-Nahari F, et al. Low preoperative prognostic nutrional index predicts poor survival in patients with newly diagnosed high-grade gliomas. J Neurooncol 2017; 132: 239-47. (doi: 10.1007/s11060-016-2361-0).
  • Trestini I, Carbognin L, Bonaiuto C, Tortora G, Bria E. The obesity paradox in cancer: clinical insights and perspectives. Eat Weight Disord 2018; 23: 185-93. (doi: 10.1007/s40519-018-0489-y).
  • Alarcon S, Niechi I, Toledo F, Sobrevia L, Quezada C. Glioma progression in diabesity. Mol Aspect Med 2019; 66: 62-70. (doi: 10.1016/j.mam.2019.02.002).
  • Park Y, Colditz GA. Diabetes and adiposity: a heavy load for cancer. Lancet Diabetes Endocrinol 2017; 6: 82-3. (doi: 10.1016/S2213-8587(17)30396-0).
  • Saeedi P, Petersohn I, Salpea P, et al. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: Results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 2019; 157: 107843. (doi: 10.1016/j.diabres.2019.107843).
  • Barami K, Lyon L, Conell C. Type 2 diabetes mellitus and glioblastoma multiforme-assessing risk and survival: Results of a large retrospective study and systematic review of the literature. World Neurosurg 2017; 106: 300-7. (doi: 10.1016/j.wneu.2017.06.164).
  • Pearson-Stuttard J, Zhou B, Kontis V, Bentham J, Gunter MJ, Ezzati M. Worldwide burden of cancer attributable to diabetes and high body-mass index: a comparative risk assessment. Lancet Diabetes Endocrinol 2018; 6: 95-104. (doi: 10.1016/S2213-8587(17)30366-2).
  • Chooi YC, Ding C, Magkos F. The epidemiology of obesity. Metabolism 2019; 92: 6-10. (doi: 10.1016/j.metabol.2018.09.005).
  • Jones LW, Ali-Osman F, Lipp E, et al. Association between body mass index and mortality in patients with glioblastoma multiforme. Cancer Causes Control 2010; 21: 2195-201. (doi: 10.1007/s10552-010-9639-x).
  • Berger NA. Obesity and cancer pathogenesis. Ann N Y Acad Sci 2014; 1311: 57-76. (doi: 10.1111/nyas.12416).
  • Huang X, Shu C, Chen L, Yao B. Impact of sex, body mass index and initial pathologic diagnosis age on the incidence and prognosis of different types of cancer. Oncol Rep 2018; 40: 1359-69. (doi: 10.3892/or.2018.6529).
  • Wang Y, Sun Y, Tang J, Zhou W, et al. Does diabetes decrease the risk of glioma? A systematic review and meta-analysis of observational studies. Ann Epidemiol 2019; 30: 22-9. (doi: 10.1016/j.annepidem.2018.11.010).
  • Tong JJ, Tao h, Hui OT, Jian C. Diabetes mellitus and risk of brain tumours: A meta-analysis. Exp Ther Med 2012; 4: 877-82. (doi: 10.3892/etm.2012.698).
  • Lu VM, Goyal A, Vaughan LS, McDonald KL. The impact of hyperglycemia on survival in glioblastoma: A systematic review and meta-analysis. Clin Neurol Neurosurg 2018; 170: 165-9. (doi: 10.1016/j.clineuro.2018.05.020).
  • Yıldırım N. Obezite ve kanser. Firat Med J 2018; 23: 61-7. (doi: 10.16990/SOBIDER.4188).
  • Derr RL, Ye X, Islas MU, Desideri S, Saudek CD, Grossman SA. Association between hyperglicemia and survival in patients with newly diagnosed glioblastoma. J Clin Oncol 2009; 27: 1082-6. (doi: 10.1200/JCO.2008.19.1098).
  • Pohharaju M, Mangaleswaran B, Mathavan A, et al. Body mass index as a prognostic marker in glioblastome multiforme: A clinical outcomes. Int J Radiat Oncol Biol Phys 2018; 102: 204-9. (doi: 10.1016/j.ijrobp.2018.05.024).
  • Wiedmann MKH, Brunborg C, Di leva A, et al. Overweight, obesity and height as risk factors for menenjioma, glioma, pituitary adenoma and nevre sheath tumor: a large population-based prospective cohort study. Acta Oncol 2017; 56: 1302-9. (doi: 10.1080/0284186X.2017.1330554).
Toplam 21 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Sağlık Kurumları Yönetimi
Bölüm Araştırma makaleleri
Yazarlar

Berrin Benli Yavuz 0000-0001-7816-4687

Gül Kanyılmaz 0000-0003-2333-353X

Meryem Aktan Bu kişi benim 0000-0002-0447-7784

Yayımlanma Tarihi 1 Haziran 2020
Yayımlandığı Sayı Yıl 2020

Kaynak Göster

Vancouver Benli Yavuz B, Kanyılmaz G, Aktan M. Prognostic significance of body mass index and diabetes in patients with malignant glioma. otd. 12(2):269-74.

e-ISSN: 2548-0251

The content of this site is intended for health care professionals. All the published articles are distributed under the terms of

Creative Commons Attribution Licence,

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.