The effect of postoperative chemotherapy on blood glucose and prognosis in patients with advanced ovarian cancer.

Objective: Recent studies have shown that chemotherapy can cause abnormal glucose metabolism in cancer patients; however, little is known about the association of blood glucose (BG) with chemotherapy in ovarian cancer. In this study, we investigated the effect of chemotherapy on glucose metabolism in patients with advanced ovarian cancer and its effect on patient prognosis.

Methods: We retrospectively analyzed blood glucose and other clinical data from 100 patients with advanced ovarian cancer (International Federation of Gynecology and Obstetrics, FIGO III/IV) before and after chemotherapy. Kaplan-Meier survival curves were used to calculate OS Overall Survival) survival curves for patients in the BG-High and BG-Low groups, and logarithmic rank statistics (Mantel-Cox) to assess associations between clinical outcomes and related indicators of patients.

Results: Of the 100 patients with advanced ovarian cancer (OC) included in this study, 49 patients (49 %) had stage III disease, and 51 had stage IV disease according to FIGO classification. In total, 65 patients (65 %) achieved R0 surgical resection, while 35 patients (35 %) achieved R1, after complete surgical resection or satisfactory cytoreductive surgery followed by paclitaxel-carboplatin chemotherapy every three weeks for a total of six cycles. According to blood glucose (BG) levels after chemotherapy, patients were divided into two groups: blood glucose ≥ 6.1mmol/L (BG High) and blood glucose < 6.1mmol/L (BG Low). Thirty-two patients (BG High) had elevated fasting blood glucose levels after chemotherapy. Of these, six patients were definitively diagnosed with diabetes, fasting BG ≥7.0 mmol/L, and 26 patients had impaired fasting blood glucose, fasting BG 6.1-6.9 mmol/L; this difference was statistically significant (P < 0.05). Kaplan-Meier analysis showed that the mean 5-year OS (probability of survival from diagnosis to 5 years post-treatment) of 100 patients with OC in this study were 33 months. The mean OS of patients in the BG-LOW group was 37 months compared to 28 months in the BG-High group; this difference was statistically significant (P <0.01). The Cox regression model indicated that post-chemotherapy blood glucose levels exerted an independent effect on OS in OC patients (hazard ratio [HR]: 3.4; 95 % confidence interval [CI]: 2.0-5.7; P < 0.01). In addition, FIGO staging and surgical R0 resection also exerted independent effects on patient survival.

Conclusion: Patients with advanced ovarian cancer experience hyperglycemia during adjuvant chemotherapy. Furthermore, an increase in blood glucose after chemotherapy is associated with a poor prognosis. Our findings identified potential chemotherapy risks and highlighted the importance of preventing hyperglycemia.