Association of Diabetes Severity and Mortality with Lung Squamous Cell Carcinoma

Chih-Hsiung Su; Wan-Ming Chen; Mingchih Chen; Ben-Chang Shia; Szu-Yuan Wu

doi:10.3390/cancers14102553

Association of Diabetes Severity and Mortality with Lung Squamous Cell Carcinoma

Cancers (Basel). 2022 May 22;14(10):2553. doi: 10.3390/cancers14102553.

Authors

Chih-Hsiung Su¹, Wan-Ming Chen^{2

3}, Mingchih Chen², Ben-Chang Shia^{2

3}, Szu-Yuan Wu^{2

3

4

5

6

7

8

9

10}

Affiliations

¹ Department of Accounting Information, Chihlee University of Technology, Taipei 22050, Taiwan.
² Graduate Institute of Business Administration, College of Management, Fu Jen Catholic University, Taipei 24205, Taiwan.
³ Artificial Intelligence Development Center, Fu Jen Catholic University, Taipei 24205, Taiwan.
⁴ Department of Food Nutrition and Health Biotechnology, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan.
⁵ Division of Radiation Oncology, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265501, Taiwan.
⁶ Big Data Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265501, Taiwan.
⁷ Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung 41354, Taiwan.
⁸ Cancer Center, Lo-Hsu Medical Foundation, Lotung Poh-Ai Hospital, Yilan 265501, Taiwan.
⁹ Centers for Regional Anesthesia and Pain Medicine, Taipei Municipal Wan Fang Hospital, Taipei Medical University, Taipei 110301, Taiwan.
¹⁰ Department of Management, College of Management, Fo Guang University, Yilan 26247, Taiwan.

Abstract

Purpose: The survival impact of diabetes severity on lung cancer remains unclear. We performed head-to-head propensity score matching to estimate the survival impact of various adapted diabetes complications severity index (aDCSI) scores in patients with both diabetes and lung squamous cell carcinoma (SqCLC).

Patients and methods: We enrolled patients with both diabetes and lung SqCLC and categorized them into the mild (aDCSI = 0-1) and moderate-to-severe (aDCSI ≥ 2) diabetes groups. The patients in both groups were matched at a 1:1 ratio.

Results: the matching process yielded a final cohort of 5742 patients with both diabetes and lung SqCLC (2871 patients in the mild diabetes group and 2871 patients in the moderate-to-severe diabetes groups) who were eligible for further analysis. A multivariate Cox regression analysis revealed that the adjusted hazard ratio (aHR; 95% confidence interval) of all-cause death for the mild diabetes group relative to the moderate-to-severe diabetes group was 1.17 (1.08-1.28; p = 0.0005).

Conclusion: severe diabetes (aDCSI ≥ 2) is an independent prognostic factor for OS among patients with both diabetes and lung SqCLC who receive standard treatments. Preventing diabetes progression is necessary for patients with diabetes because it not only supports diabetes control but also improves survival for patients with lung SqCLC.

Keywords: lung cancer; propensity scores matching; severity of diabetes; squamous cell carcinoma; survival.

Grants and funding

Lo-Hsu Medical Foundation, LotungPoh-Ai Hospital, supports Szu-Yuan Wu’s work (Funding Number: 10908, 10909, 11001, 11002, 11003, 11006, and 11013). Fu Jen Catholic University supports Ben-Chang Shia’s work (Funding Number: A0110180 and A0110182).