The impact of preoperative glycated hemoglobin levels on outcomes in oral squamous cell carcinoma

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Abstract
Objectives: This study aimed to investigate the association between preoperative glycated hemoglobin (HbA1c) levels and the treatment outcomes of oral cavity squamous cell carcinoma (OSCC).Methods: Three hundred and fifty‐eight OSCC patients were consecutively enrolled between July 2004 and July 2016. Clinicopathological parameters and survival outcomes were analyzed following HbA1c stratification of 6.5% (HbA1c ≥ 6.5%: n = 74, 20.6%) and 7.0% (HbA1c ≥ 7.0%: n = 53, 14.8%).Results: Higher HbA1c levels were associated with elevated body mass index, lower albumin levels, wider surgical margins, and prolonged hospital stays (HbA1c 6.5%: p = .001, .048, .030, .009, respectively; HbA1c 7.0%: p = .092, .032, .009, .015, respectively). Survival rates stratified by HbA1c 6.5% were as follows: locoregional recurrence‐free survival, p = .014; distant metastasis‐free survival, p = .013; second primary cancer‐free survival, p = .015; overall survival, p = .014; disease‐specific survival, p = .002 and HbA1c 7.0%: locoregional recurrence‐free survival, p = .013; distant metastasis‐free survival, p = .013; second primary cancer‐free survival, p = .014; overall survival, p = .015; disease‐specific survival, p = .004. Multivariate analyses identified HbA1c as an independent prognostic factor for overall and disease‐specific survival (HbA1c 6.5%: p = .014 and .002, respectively; HbA1c 7.0%: p = .036 and .013, respectively).Conclusions: Oral squamous cell carcinoma patients with higher preoperative HbA1c levels had longer hospitalization and worse survival outcomes.

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