Confirmation of the role of diabetes in the local recurrence of surgically resected non-small cell lung cancer

J. Varlotto, L. N. Medford-Davis, A. Recht, J. Flickinger, E. Schaefer, J. Shelkey, M. Lazar, David Campbell, M. Nikolov, M. M. DeCamp

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Abstract

Purpose: We recently demonstrated that diabetes mellitus was an independent risk factor for local recurrence (LR) for patients undergoing resection of non-small cell lung cancer (NSCLC). This investigation was performed to confirm or refute this finding in a different patient cohort. Materials and methods: Patients were eligible if they did not have a second primary cancer within 5 years of the original diagnosis, had at least 3-month follow-up, and did not receive radiotherapy. There were 373 and 168 patients in the original (P1) and confirmatory (P2) cohorts, respectively, with 66 and 30 patients with diabetes. Results: The median follow-up was 33 months (range, 3-98 months). Diabetes was an independent risk factor for LR in a Cox model in both the P2 (p=. 0.05, hazard ratio [HR] 2.15) and P1 (p=. 0.008, HR 1.90) cohorts, separately from BMI, glucose control, and the presence of the metabolic syndrome. The rates of LR in the patients with diabetes after combining the cohorts at 2, 3, and 5 years were 23%, 33%, and 56%, respectively; these rates were 15%, 19%, and 26% in non-diabetics. In multivariate Cox regression and competing risk analysis of the combined cohorts, the HRs for LR in patients with diabetes exceeded those of more established risk factors for LR including a 1-cm increase in tumor size and lymphovascular invasion. Conclusions: Diabetes was confirmed to be an independent predictor of the risk of LR following resection of NSCLC.

Original languageEnglish (US)
Pages (from-to)381-390
Number of pages10
JournalLung Cancer
Volume75
Issue number3
DOIs
StatePublished - Mar 1 2012

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Non-Small Cell Lung Carcinoma
Recurrence
Second Primary Neoplasms
Proportional Hazards Models
Diabetes Mellitus
Cohort Studies
Radiotherapy
Glucose
Neoplasms

All Science Journal Classification (ASJC) codes

  • Oncology
  • Pulmonary and Respiratory Medicine
  • Cancer Research

Cite this

Varlotto, J., Medford-Davis, L. N., Recht, A., Flickinger, J., Schaefer, E., Shelkey, J., ... DeCamp, M. M. (2012). Confirmation of the role of diabetes in the local recurrence of surgically resected non-small cell lung cancer. Lung Cancer, 75(3), 381-390. https://doi.org/10.1016/j.lungcan.2011.07.019
Varlotto, J. ; Medford-Davis, L. N. ; Recht, A. ; Flickinger, J. ; Schaefer, E. ; Shelkey, J. ; Lazar, M. ; Campbell, David ; Nikolov, M. ; DeCamp, M. M. / Confirmation of the role of diabetes in the local recurrence of surgically resected non-small cell lung cancer. In: Lung Cancer. 2012 ; Vol. 75, No. 3. pp. 381-390.
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abstract = "Purpose: We recently demonstrated that diabetes mellitus was an independent risk factor for local recurrence (LR) for patients undergoing resection of non-small cell lung cancer (NSCLC). This investigation was performed to confirm or refute this finding in a different patient cohort. Materials and methods: Patients were eligible if they did not have a second primary cancer within 5 years of the original diagnosis, had at least 3-month follow-up, and did not receive radiotherapy. There were 373 and 168 patients in the original (P1) and confirmatory (P2) cohorts, respectively, with 66 and 30 patients with diabetes. Results: The median follow-up was 33 months (range, 3-98 months). Diabetes was an independent risk factor for LR in a Cox model in both the P2 (p=. 0.05, hazard ratio [HR] 2.15) and P1 (p=. 0.008, HR 1.90) cohorts, separately from BMI, glucose control, and the presence of the metabolic syndrome. The rates of LR in the patients with diabetes after combining the cohorts at 2, 3, and 5 years were 23{\%}, 33{\%}, and 56{\%}, respectively; these rates were 15{\%}, 19{\%}, and 26{\%} in non-diabetics. In multivariate Cox regression and competing risk analysis of the combined cohorts, the HRs for LR in patients with diabetes exceeded those of more established risk factors for LR including a 1-cm increase in tumor size and lymphovascular invasion. Conclusions: Diabetes was confirmed to be an independent predictor of the risk of LR following resection of NSCLC.",
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Varlotto, J, Medford-Davis, LN, Recht, A, Flickinger, J, Schaefer, E, Shelkey, J, Lazar, M, Campbell, D, Nikolov, M & DeCamp, MM 2012, 'Confirmation of the role of diabetes in the local recurrence of surgically resected non-small cell lung cancer', Lung Cancer, vol. 75, no. 3, pp. 381-390. https://doi.org/10.1016/j.lungcan.2011.07.019

Confirmation of the role of diabetes in the local recurrence of surgically resected non-small cell lung cancer. / Varlotto, J.; Medford-Davis, L. N.; Recht, A.; Flickinger, J.; Schaefer, E.; Shelkey, J.; Lazar, M.; Campbell, David; Nikolov, M.; DeCamp, M. M.

In: Lung Cancer, Vol. 75, No. 3, 01.03.2012, p. 381-390.

Research output: Contribution to journalArticle

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T1 - Confirmation of the role of diabetes in the local recurrence of surgically resected non-small cell lung cancer

AU - Varlotto, J.

AU - Medford-Davis, L. N.

AU - Recht, A.

AU - Flickinger, J.

AU - Schaefer, E.

AU - Shelkey, J.

AU - Lazar, M.

AU - Campbell, David

AU - Nikolov, M.

AU - DeCamp, M. M.

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N2 - Purpose: We recently demonstrated that diabetes mellitus was an independent risk factor for local recurrence (LR) for patients undergoing resection of non-small cell lung cancer (NSCLC). This investigation was performed to confirm or refute this finding in a different patient cohort. Materials and methods: Patients were eligible if they did not have a second primary cancer within 5 years of the original diagnosis, had at least 3-month follow-up, and did not receive radiotherapy. There were 373 and 168 patients in the original (P1) and confirmatory (P2) cohorts, respectively, with 66 and 30 patients with diabetes. Results: The median follow-up was 33 months (range, 3-98 months). Diabetes was an independent risk factor for LR in a Cox model in both the P2 (p=. 0.05, hazard ratio [HR] 2.15) and P1 (p=. 0.008, HR 1.90) cohorts, separately from BMI, glucose control, and the presence of the metabolic syndrome. The rates of LR in the patients with diabetes after combining the cohorts at 2, 3, and 5 years were 23%, 33%, and 56%, respectively; these rates were 15%, 19%, and 26% in non-diabetics. In multivariate Cox regression and competing risk analysis of the combined cohorts, the HRs for LR in patients with diabetes exceeded those of more established risk factors for LR including a 1-cm increase in tumor size and lymphovascular invasion. Conclusions: Diabetes was confirmed to be an independent predictor of the risk of LR following resection of NSCLC.

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Varlotto J, Medford-Davis LN, Recht A, Flickinger J, Schaefer E, Shelkey J et al. Confirmation of the role of diabetes in the local recurrence of surgically resected non-small cell lung cancer. Lung Cancer. 2012 Mar 1;75(3):381-390. https://doi.org/10.1016/j.lungcan.2011.07.019