Glycemic control in diabetic patients improved overall lung cancer survival across diverse populations
Document Type
Article
Publication Date
9-12-2024
Publication Title
JNCI Cancer Spectrum
Abstract
Background: The consequence of diabetes on lung cancer overall survival (OS) is debated. This retrospective study used 2 large lung cancer databases to assess comprehensively diabetes effects on lung cancer OS in diverse demographic populations, including health disparity. Methods: The University of Texas MD Anderson Cancer Center database (32 643 lung cancer patients with 11 973 patients with diabetes) was extracted from electronic health records (EHRs) using natural language processing (NLP). Associations were between diabetes and lung cancer prognostic features (age, sex, race, body mass index [BMI], insurance status, smoking, stage, and histopathology). Hemoglobin A1C (HgbA1c) and glucose levels assessed glycemic control. Validation was with a Louisiana cohort (17 768 lung cancer patients with 5402 patients with diabetes) enriched for health disparity cases. Kaplan-Meier analysis, log-rank test, multivariable Cox proportional hazard models, and survival tree analyses were employed. Results: Lung cancer patients with diabetes exhibited marginally elevated OS or no statistically significant difference versus nondiabetic patients. When examining OS for 2 glycemic levels (HgbA1c > 7.0 or glucose > 154 mg/dL vs HgbA1c > 9.0 or glucose > 215 mg/dL), a statistically significant improvement in OS occurred in lung cancer patients with controlled versus uncontrolled glycemia (P < .0001). This improvement spanned sex, age, smoking status, insurance status, stage, race, BMI, histopathology, and therapy. Survival tree analysis revealed that obese and morbidly obese patients with controlled glycemia had higher lung cancer OS than comparison groups. Conclusion: These findings indicate a need for optimal glycemic control to improve lung cancer OS in diverse populations with diabetes.
PubMed ID
39270065
Volume
8
Issue
5
Chapter Title
081 - Glycemic control in diabetic patients improved overall lung cancer survival across diverse populations
Recommended Citation
Wu, Wayne Y.; Luke, Brian; Wu, Xiao Cheng; Lee, J. Jack; Yi, Yong; Okpechi, Samuel C.; Gause, Barry; Mehta, Paras; Sherman, Steven I.; Ochoa, Augusto; Dmitrovsky, Ethan; and Liu, Xi, "Glycemic control in diabetic patients improved overall lung cancer survival across diverse populations" (2024). School of Public Health Faculty Publications. 429.
https://digitalscholar.lsuhsc.edu/soph_facpubs/429
10.1093/jncics/pkae081