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Prognostic value of preoperative diabetes mellitus in patients with non-functional pancreatic neuroendocrine neoplasms

  • Author Footnotes
    1 contributed equally to this work.
    Qingquan Tan
    Footnotes
    1 contributed equally to this work.
    Affiliations
    Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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  • Author Footnotes
    1 contributed equally to this work.
    Xing Wang
    Footnotes
    1 contributed equally to this work.
    Affiliations
    Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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  • Chen Chen
    Affiliations
    Department of Radiology, The First People's Hospital of Chengdu, Chengdu, Sichuan Province, China
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  • Xubao Liu
    Affiliations
    Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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  • Yonghua Chen
    Correspondence
    Corresponding author. Department of Pancreatic Surgery, West China Hospital, Sichuan University No 37, Guo Xue Alley, Chengdu, Sichuan, 610041, China.
    Affiliations
    Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
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  • Chunlu Tan
    Correspondence
    Corresponding author. Department of Pancreatic Surgery, West China Hospital, Sichuan University No 37, Guo Xue Alley, Chengdu, Sichuan, 610041, China.
    Affiliations
    Department of Pancreatic Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
    Search for articles by this author
  • Author Footnotes
    1 contributed equally to this work.

      Highlights

      • The prevalence of new-onset DM and IFG in patients with NF-PNENs are relatively high.
      • Preoperative new-onset DM and IFG are associated with aggressive tumor behavior and poor prognosis in patients with NF-PNENs.
      • Preoperative longstanding DM is not associated with tumor malignancy or survival of NF-PNENs.
      • Metformin use may not influence the prognosis of NF-PNENs with DM.

      Abstract

      Background

      The main aim of this study was to investigate the prevalence and prognostic value of preoperative diabetes mellitus (DM) in patients with non-functional pancreatic neuroendocrine neoplasms (NF-PNENs).

      Methods

      Data were retrospectively collected from 190 patients with NF-PNENs from January 2009 to December 2019 in a single center.

      Results

      The prevalence of longstanding DM, new-onset DM and impaired fasting glucose (IFG) was 11.6% (22/190), 8.4% (16/190), and 25.8% (49/190), respectively. Regression analysis showed that tumor size, tumor grade and lymph node metastasis were risk factors for new-onset DM and IFG. Multivariate survival analysis demonstrated preoperative new-onset DM (hazard ratio [HR], 4.33; P = 0.009) and IFG (HR, 4.53; P = 0.027) as independent predictors of poor recurrence-free survival (RFS) in patients with NF-PNENs.

      Conclusion

      Preoperative new-onset DM and IFG are associated with aggressive tumor behavior and poor RFS in patients with NF-PNENs.

      Keywords

      Abbreviations:

      PNENs (Pancreatic neuroendocrine neoplasms), NF-PNENs (Non-functional pancreatic neuroendocrine neoplasms), DM (Diabetes mellitus), IFG (Impaired fasting glucose)
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