Relationship between Plasma Glucose Levels and Malignant Uterine Cervical Neoplasias

Nomelini, Rosekeila Simõtes; Neto, Adriano Souza Lima; Capuci, Kalebe Alexandre; Murta, Beatriz Martins Tavares; Murta, Eddie Fernando Cândido

doi:10.4137/cmo.s6916

Cited by 9 publications

(12 citation statements)

References 38 publications

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“…They reported that patients with glucose levels ≥102 mg/dl had decreased CSS time and progression-free intervals after adjusting for other clinical factors. In the study by Rosekeila et al ., levels of plasma glucose were observed to be significantly higher in patients with invasive cervical cancer compared with patients with benign disease (leiomyoma) and those with pre-invasive disease (cervical intraepithelial neoplasia [CIN] I-III) [19]. On the other hand, Choi et al .…”

Section: Discussionmentioning

confidence: 99%

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Impact of Hyperglycemia on Outcomes among Patients Receiving Neoadjuvant Chemotherapy for Bulky Early Stage Cervical Cancer

et al. 2016

PLoS ONE

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BackgroundThe impact of hyperglycemia on survival of patients undergoing neoadjuvant chemotherapy (NACT) for bulky early stage cervical cancer (BESCC) has not been explored.MethodRecords of patients who received NACT and radical hysterectomy in our institution between January 2005 and June 2010 were reviewed.ResultsIn total, 347 patients were included. The median follow-up time was 37 months (range: 4–65). Patients with hyperglycemia (fasting blood glucose ≥ 100 mg/dl) had shorter recurrence-free survival (RFS) (univariate hazard ratio [HR] = 1.95, 95% confidence interval [CI] [1.16, 3.28], P = 0.010) and cancer-specific survival (CSS) (univariate HR = 2.24, 95% CI [1.33, 3.78], P = 0.002) compared with those with euglycemia (fasting blood glucose <100 mg/dl). In multivariate analysis, positive surgical margins, parametrium invasion, node metastasis, hyperglycemia and complete response to NACT independently predicted recurrence and cancer-specific death. To further validate the prognostic value of hyperglycemia, we conducted a subgroup analysis based on patient baseline characteristics and prognostic effect of hyperglycemia remained significant in all subgroups. On multivariable logistic regression analysis, euglycemia before NACT, squamous cell tumor and pre-treatment squamous cell carcinoma antigen levels < 3.5 ng/ml were identified as independent predictors of complete response after NACT.ConclusionsFBG ≥100 mg/dl is a negative prognostic predictor for cervical cancer patients receiving NACT for BESCC. Patients with hyperglycemia are less likely to achieve complete response after NACT. Our findings underscore the clinical utility of hyperglycemia screening of for cervical cancer patients.

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Section: Discussionmentioning

confidence: 99%

“…Of these studies, three enrolled patients with cervical cancer [18, 19, 22]. However, patients included in these studies did not receive NACT and their baseline characteristics varied significantly with regard to tumor stage and treatment modality.…”

Section: Introductionmentioning

confidence: 99%

Impact of Hyperglycemia on Outcomes among Patients Receiving Neoadjuvant Chemotherapy for Bulky Early Stage Cervical Cancer

et al. 2016

PLoS ONE

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“…There is a growing body of evidence that cancer patients with hyperglycemia have poor responses to chemotherapy . For cervical cancer patients, previous studies have revealed that an elevated level of fasting blood glucose (FBG) is a negative prognostic factor . For LACC patients, we previously reported that hyperglycemia before NACT is independently associated with a decreased likelihood of CR .…”

Section: Introductionmentioning

confidence: 97%

“…[14][15][16][17][18] For cervical cancer patients, previous studies have revealed that an elevated level of fasting blood glucose (FBG) is a negative prognostic factor. 15,[18][19][20] For LACC patients, we previously reported that hyperglycemia before NACT is independently associated with a decreased likelihood of CR. 15 However, no data have supported that combining pretreatment SCCA and FBG levels improves the prediction of CR following NACT or refines the prognostic stratification of LACC patients.…”

Section: Introductionmentioning

confidence: 99%

The added value of fasting blood glucose to serum squamous cell carcinoma antigen for predicting oncological outcomes in cervical cancer patients receiving neoadjuvant chemotherapy followed by radical hysterectomy

Guan

Liu

et al. 2019

Cancer Medicine

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Objective To determine the combination of fasting blood glucose (FBG) with squamous cell carcinoma antigen (SCCA) assessments in the prediction of tumor responses to chemotherapy and pretreatment prognostication among patients receiving neoadjuvant chemotherapy (NACT) for locally advanced cervical cancer (LACC). Methods Data of 347 LACC patients were retrospectively reviewed. Receiver operating characteristic (ROC) curves were constructed, and areas under the curves (AUCs) were compared to evaluate the ability to predict complete response (CR) following NACT. Patients were stratified into groups with low and high levels of SCCA and FBG and combined into low‐ or high‐SCCA and low‐ or high‐FBG groups. Cox regression analysis was performed to identify determinants of recurrence‐free survival (RFS) and overall survival (OS). Results The AUCs were 0.70, 0.68, and 0.66 for SCCA, FBG, and a combination of SCCA and FBG for predicting CR following NACT, respectively; however, the differences among AUCs were not significant ( P = .496). Pretreatment SCCA and FBG levels were identified as independent predictors of RFS and OS. The high‐SCCA/high‐FBG group showed significantly worse prognosis than the low‐SCCA/low‐FBG group. After adjusting for other variables, high‐SCCA/high‐FBG remained independently associated with an increased risk of tumor recurrence and death. Conclusion SCCA, FBG, and a combination of SCCA and FBG could acceptably predict CR following NACT. Pretreatment SCCA and FBG levels were independent prognostic factors. The combination of SCCA and FBG levels refined the prognostic stratification of LACC patients, which allowed the group of patients with the highest risk of recurrence and death to be identified.

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“…A higher frequency of changes in leukocytes in peripheral blood was found in patients with advanced cancer of the cervix, and neutrophilia could be an indicator of tumor invasiveness [ 16 ]. Another study showed that patients with cervical neoplasias with poor prognosis had higher plasma glucose levels than those with less aggressive lesions [ 17 ]. In ovarian malignancies, hemoglobin levels before and during chemotherapy may be important prognostic factors [ 18 – 20 ], and the hemoglobin concentration had a prognostic factor in oral squamous carcinoma [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

Parameters of Blood Count and Tumor Markers in Patients with Borderline Ovarian Tumors: A Retrospective Analysis and Relation to Staging

et al. 2012

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The aim of this paper was to evaluate the parameters of blood count and tumor markers in borderline ovarian tumors. We evaluated 21 patients who had confirmed histopathologic diagnosis of borderline ovarian tumor. We recorded age, parity, tumor type, stage of cancer, serum levels of tumor markers (CA-125, CA-15.3, CA-19.9, CEA, AFP), and the parameters of blood count, fasting glucose, disease-free survival and overall. The patients were divided into two groups, stage IA (n = 13) and stage IB-IIIC (n = 8). The unpaired t-test and Fisher's exact test were used, with P values of less than 0.05 being considered to indicate statistical significance. Levels of red blood cells, hematocrit, and hemoglobin were significantly higher in stage IA when compared with stage IB-IIIC (P < 0.05). The levels of tumor marker CEA had a tendency to be higher in the group stage IB-IIIC (0.08). Abnormal levels of CEA and CA-19.9 were found more frequently in stages IB-IIIC. Therefore, parameters of blood count, CEA, and CA-19.9 should be targeted for further research in identifying prognostic factors in borderline tumors.

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Relationship between Plasma Glucose Levels and Malignant Uterine Cervical Neoplasias

Cited by 9 publications

References 38 publications

Impact of Hyperglycemia on Outcomes among Patients Receiving Neoadjuvant Chemotherapy for Bulky Early Stage Cervical Cancer

Impact of Hyperglycemia on Outcomes among Patients Receiving Neoadjuvant Chemotherapy for Bulky Early Stage Cervical Cancer

The added value of fasting blood glucose to serum squamous cell carcinoma antigen for predicting oncological outcomes in cervical cancer patients receiving neoadjuvant chemotherapy followed by radical hysterectomy

Parameters of Blood Count and Tumor Markers in Patients with Borderline Ovarian Tumors: A Retrospective Analysis and Relation to Staging

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