The Relationship Between Preoperative Hyperglycemia and Overall Survival After Gastric Cancer Surgery

Abstract ObjectiveHyperglycemia has been linked to the long-term prognosis of various malignant tumors. This study specifically examined the association between preoperative hyperglycemia and the long-term prognosis of gastric cancer after surgery.MethodsThis study included 1,109 patients who underwent gastric cancer resection with curative intent at the Sixth Affiliated Hospital of Sun Yat-Sen University between January 2018 and December 2021. Patients were divided into hyperglycemia and non-hyperglycemia groups with preoperative fasting blood glucose (FBG) cut-off value of 126 mg/dL. Cox regression analysis and Kaplan-Meier survival curves were then employed to assess the relationship between hyperglycemia and overall survival (OS) in the entire cohort. Finally, a subgroup analysis was conducted to further explore these associations.ResultsAmong the 1,109 patients, 121 (10.9%) were hyperglycemia and 988 (89.1%) were non-hyperglycemia. The 5-year overall survival (OS) rate was 64.9% for non-hyperglycemia patients and 41.3% for hyperglycemia patients. Kaplan-Meier survival curves indicated a significantly increased risk of mortality in hyperglycemia patients (log rank, P < 0.001). Compared to non-hyperglycemia patients, those with hyperglycemia had lower odds of overall survival (adjusted Hazard Ratio: 1.74, 95% CI: 1.31–2.32).ConclusionPreoperative hyperglycemia (preoperative FBG ≥ 126 mg/dL) is a risk factor for the long-term prognosis of gastric cancer.