The Impact of Postoperative Blood Glucose Levels on Complications and Prognosis After Esophagectomy in Patients with Esophageal Cancer

Overview

Journal Surg Today

Specialty General Surgery

Date 2023 Jan 19

PMID 36658255

Authors

Chihiro Koga

Kotaro Yamashita

Yoshiro Yukawa

Koji Tanaka

Tomoki Makino

Takuro Saito

Kazuyoshi Yamamoto

Tsuyoshi Takahashi

Yukinori Kurokawa

Kiyokazu Nakajima

Hidetoshi Eguchi

Yuichiro Doki

Affiliations

Soon will be listed here.

Abstract

Purpose: This study aimed to characterize postoperative blood glucose fluctuation in patients who underwent esophagectomy for esophageal cancer, and to define its impact on complications and prognosis.

Methods: The subjects of this retrospective study were 284 patients who underwent esophagectomy at Osaka University Hospital between 2015 and 2017. Data analyzed included clinicopathological background, the immediate postoperative blood glucose level (IPBG), postoperative blood glucose variability (PBGV), insulin dosage, postoperative complications, and prognosis.

Results: The median IPBG and PBGV were 170 (64-260) mg/dl and 64.5 (11-217) mg/dl, respectively. Postoperative pneumonia was more common in patients with PBGV > 100 mg/dl (P = 0.015). Patients with IPBG < 170 mg/dl had significantly worse 5-year overall survival (OS) and 5-year recurrence-free survival (RFS) than those with IPBG > 170 mg/dl (54.5% vs. 80.4%, respectively, [P < 0.001] and 44.3% vs. 69.3%, respectively, [P = 0.001]). The 5-year OS rates were 43.5%, 68.3%, 80.6%, and 79.0% for patients with IPBG < 154, 154-170, 170-190, and ≥ 190 mg/dl, respectively. The corresponding 5-year RFS rates were 38.1%, 52.4%, 77.0%, and 61.3%, respectively. Multivariate analysis revealed that IPBG < 154 mg/dl and pathological stage were independent poor prognostic factors for OS.

Conclusion: PBGV was associated with postoperative pneumonia, and low IPBG was an independent poor prognostic factor for patients with esophageal cancer.

Citing Articles

Low preoperative hemoglobin A1c level is a predictor of perioperative infectious complications after esophagectomy: A retrospective, single-center study.

Kato D, Yamada K, Enomoto N, Yagi S, Koda H, Nohara K Glob Health Med. 2024; 6(3):190-198.

PMID: 38947405 PMC: 11197158. DOI: 10.35772/ghm.2023.01113.

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