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Prognostic relevance of insulin resistance on disease‐free survival in head and neck squamous cell carcinomas: Preliminary results
Author(s) -
AvilésJurado Francesc Xavier,
Flores Joan Carles,
Gumà Josep,
CeperueloMallafré Victoria,
CasanovaMarqués Raquel,
Gómez David,
Vendrell Joan Josep,
León Xavier,
Vilaseca Isabel,
Terra Ximena
Publication year - 2017
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.24919
Subject(s) - medicine , insulin resistance , oncology , head and neck squamous cell carcinoma , head and neck cancer , stage (stratigraphy) , glycemic , disease , confidence interval , gastroenterology , cancer , insulin , biology , paleontology
Background The primary purpose of this study was to investigate the significance of pretreatment glycemic parameters in the prognosis of head and neck squamous cell carcinoma (HNSCC). Methods Plasma samples of 71 patients with untreated HNSCC were obtained at the time of diagnosis. The prognostic value of fasting insulin, glucose, glycosylated hemoglobin levels, and the homeostatic model of risk assessment‐insulin resistance (HOMA‐IR) was evaluated toward disease‐free survival. Results High HOMA‐IR levels were associated with poor disease‐free survival in intermediate‐advanced stage tumors. Kaplan‐Meier curves showed lower disease‐free survival rates in patients with high HOMA‐IR than in patients with low levels. In patients with intermediate‐advanced stage tumors, multivariate analysis revealed that those with an HOMA‐IR >2.974 presented a 2.7 times higher risk of poor outcome (95% confidence interval [CI] 1.023‐7.341; P = .045). Conclusion The HOMA‐IR is independently associated with disease‐free survival in patients with HNSCC. We found an optimal HOMA‐IR cutoff value for disease‐free survival in patients with intermediate‐advanced HNSCC.