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, 115 (5), 1021-7

Glucose as a Prognostic Factor in Ovarian Carcinoma

Glucose as a Prognostic Factor in Ovarian Carcinoma

Donald M Lamkin et al. Cancer.

Abstract

Background: Research suggests that glucose levels in cancer patients may be an important prognostic indicator. In ovarian tumors, increased expression of glucose transporter 1 (GLUT1), a transmembrane protein responsible for glucose uptake, is related to shorter survival time in ovarian cancer patients. This study tested the hypothesis that higher presurgical glucose levels predict shorter disease-specific survival time and time to recurrence in ovarian cancer patients.

Methods: Nonfasting plasma glucose levels were determined for 74 patients with ovarian cancer at the time of their presurgical consultation and for 125 ovarian cancer patients in an independent validation set. Survival time and time to recurrence (disease-free interval [DFI]) were ascertained from medical records. Cox proportional hazards regression models were used to estimate the hazard ratio (HR) for survival time and DFI in relation to glucose level, adjusting for body mass index (BMI), stage, grade, and cytoreduction as appropriate.

Results: Higher glucose levels were associated with shorter survival times in univariate analyses (HR, 1.88; P = .05). Multivariate analysis adjusting for stage showed that higher glucose levels were associated with shorter survival times (HR, 2.01; P = .04) and DFI (HR, 2.32; P = .05). In the validation set, higher glucose levels were associated with shorter survival times (HR, 2.01; P = .02) and DFI (HR, 2.48; P = .001) in univariate analysis, although glucose was not independent of the effect of cytoreduction when predicting survival time in this latter set.

Conclusions: These findings contribute to mounting evidence that glucose levels have prognostic value in ovarian carcinoma.

Figures

Figure 1
Figure 1
Survival time for a hyperglycemic patient with a postprandial glucose level of 140 mg/dL versus a patient at the low end of the normal postprandial range with a glucose level of 70 mg/dL, adjusting for stage and time of blood draw. Cox regression indicates that patients with higher glucose levels before surgery had shorter survival times (P = 0.04).
Figure 2
Figure 2
DFI for a hyperglycemic patient with a postprandial glucose of 140 mg/dL versus a patient at the low end of the normal postprandial range with a glucose level of 70 mg/dL, adjusting for stage and time of blood draw. Cox regression indicates that patients with higher glucose levels before surgery had shorter DFI (P = 0.05).

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