Poor Glycemic Control Is Associated with Failure to Complete Neoadjuvant Therapy and Surgery in Patients with...

Area of Science:

• Oncology
• Endocrinology
• Surgical Oncology

Background:

• The role of glycemic control in pancreatic cancer patients undergoing neoadjuvant therapy remains unclear.
• Assessing the impact of blood glucose management on treatment outcomes is crucial for optimizing patient care.

Purpose of the Study:

• To investigate the association between glycemic control, measured by glycated hemoglobin (HbA1c), and treatment completion in localized pancreatic cancer patients receiving neoadjuvant therapy.
• To determine if glycemic control impacts the risk of metastatic progression during neoadjuvant treatment.

Main Methods:

• Glycated hemoglobin (HbA1c) levels were measured pre-therapy and pre-surgery in localized pancreatic cancer patients.
• Patients were grouped based on HbA1c changes: always normal, worsened, improved, or always abnormal.
• Treatment completion and metastatic progression were analyzed in relation to preoperative HbA1c levels.

Main Results:

• Of 123 patients, 67 had normal HbA1c throughout, while 26 had persistently abnormal levels.
• Patients with abnormal preoperative HbA1c and borderline resectable disease were less likely to complete neoadjuvant therapy and surgery.
• Elevated preoperative HbA1c showed a trend towards increased odds of metastatic progression (p=0.08).

Conclusions:

• Elevated preoperative glycated hemoglobin (HbA1c) is associated with failure to complete neoadjuvant therapy and surgery in pancreatic cancer.
• Poor glycemic control may indicate an increased risk of metastatic progression during neoadjuvant treatment.