The impact of preoperative glycated hemoglobin levels on outcomes in oral squamous cell carcinoma

Abstract

Objectives This study aimed to investigate the association between preoperative glycated hemoglobin (HbA1c) levels and the treatment outcomes of oral cavity squamous cell carcinoma (OSCC). Methods Three hundred and fifty‐eight OSCC patients were consecutively enrolled between July 2004 and July 2016. Clinicopathological parameters and survival outcomes were analyzed following HbA1c stratification of 6.5% (HbA1c ≥ 6.5%: n = 74, 20.6%) and 7.0% (HbA1c ≥ 7.0%: n = 53, 14.8%). Results Higher HbA1c levels were associated with elevated body mass index, lower albumin levels, wider surgical margins, and prolonged hospital stays (HbA1c 6.5%: p = .001, .048, .030, .009, respectively; HbA1c 7.0%: p = .092, .032, .009, .015, respectively). Survival rates stratified by HbA1c 6.5% were as follows: locoregional recurrence‐free survival, p = .014; distant metastasis‐free survival, p = .013; second primary cancer‐free survival, p = .015; overall survival, p = .014; disease‐specific survival, p = .002 and HbA1c 7.0%: locoregional recurrence‐free survival, p = .013; distant metastasis‐free survival, p = .013; second primary cancer‐free survival, p = .014; overall survival, p = .015; disease‐specific survival, p = .004. Multivariate analyses identified HbA1c as an independent prognostic factor for overall and disease‐specific survival (HbA1c 6.5%: p = .014 and .002, respectively; HbA1c 7.0%: p = .036 and .013, respectively). Conclusions Oral squamous cell carcinoma patients with higher preoperative HbA1c levels had longer hospitalization and worse survival outcomes.

Point-of-care HbA1c Measurements in Oral Cancer and Control Patients in Hungary

“…It is questionable whether POC HbA1 is an important tool to detect metabolic disorders, or track the status of the therapy. Studies from 2010 and onwards show controversial data on the use of POC instruments for diagnosis: only a few devices meet the acceptable performance criteria and how the test will perform in the hands of non-professionals is questionable (33). The authors' opinion is that in dental office diagnosis of DM is not the responsibility of the dentist, however a very important prevention stage, as if abnormal values are being detected, further interdisciplinary approach is possible by DM care providers.…”