Li Min¹, Jiang Hua², Wang Lin-wei³, Li Ju-fen⁴, Sun Rui⁴, Gao Chang⁴, Zhou Yong⁴, Lin Mei⁴, Su Yan-wei⁴, Feng Jue-ping⁴

¹Department of Oncology, PuAi Hospital of Tongji Medical College, Huazhong University of Science and Technology, China, ²University of Science and Technology of China, School of Life Sciences and Medical Center, ³Zhongnan Hospital of Wuhan University, ⁴Huazhong University of Science and Technology, Wuhan PuAi Hospital of Tongji Medical College

Objective:To explore the association between 5-FU-basedchemotherapy associated hyperglycemia and 5-year outcome of CRC patients. Method: A retrospective analysis was performed in this study to explore the association between 5-FU-basedchemotherapy associated hyperglycemia and 5-year outcome of 564 cases CRC patients. Result: The secondary hyperglycemia was associated with worse 5-year overall survival (OS) (47.1% in hyperglycemia vs 60.2% in non-hyperglycemia, P=0.009). A significant difference in cancer-specific OS was observed in hyperglycemia vs non-hyperglycemia groups (50.6% vs 61.2%, P=0.032). Multivariate analysis identified that hyperglycemia were independent prognostic factors for both OS and progression-free survival (PFS) (P<0.001), wherein, diabetes have a higher death risk than IFG/ IGT (HR 2.025, 95% CI [1.335-3.070] vs HR 1.664, 95% CI [1.062-2.605]). The patients with hyperglycemia had a more prone to stopping chemotherapy or shifting to more tolerable therapies due to adverse events (AEs) (P=0.028).There was a higher incidence of non-cancer mortality (P=0.043), liver (P=0.036) and lung metastasis (P=0.002) in hyperglycemia than non-hyperglycemia groups. Conclusion: The secondary hyperglycemia, especially diabetes was a high-risk factor for both cancer-specific and non-cancer deaths for CRC patients, possible partially caused by the increased adverse events, decreased chemotherapy compliance, and increased liver and lung metastasis.

Key Words: colorectal cancer  5-fluorouracil  hyperglycemia