Postoperative blood glucose levels: A predictor of poor survival in resected pancreatic cancer

Abstract Background: Although pancreatic resection influences glucose metabolism, the clinical impact of postoperative fasting blood glucose (FBG) on survival outcomes in patients undergoing curative-intent resection for pancreatic cancer remains unreported. Methods: Data from patients who underwent curative-intent resection for pancreatic cancer and have diabetic status records were retrieved from a prospectively maintained database from November 2010 to May 2017. Postoperative FBG was measured at 2–4 months after surgery. Patients were stratified into high (≥7.0 mmol/L) and normal (<7.0 mmol/L) FBG groups. Propensity score matching was applied to balance baseline covariates. Survival curves were assessed by the Kaplan–Meier method and compared using the log-rank test. Results: Among 531 patients, 161 (30.3%) had high postoperative FBG. High postoperative FBG was associated with a tumor located in the body and tail of the pancreas ( P =0.002) and a history of diabetes ( P <0.001). The median survival time was 18.4 months among patients in the high FBG group, compared with 31.3 months in the normal group ( P =0.012). Postoperative FBG was associated with outcomes on multivariable Cox proportional hazards regression (hazard ratio [HR]=1.52, 95% confidence interval [CI], 1.11–2.07, P =0.008). After propensity score matching, high postoperative FBG remained associated with worse survival (HR=1.64, 95% CI, 1.10–2.44, P =0.014). Conclusions: High postoperative blood glucose predicts poor outcome among patients with resected pancreatic cancer. It is important to monitor postoperative blood glucose among patients with resected pancreatic cancer, especially for patients with preoperative diabetes or tumors located at the body and tail of the pancreas.