Glucose levels predict outcomes in ovarian carcinoma

NEW YORK (Reuters Health) - Higher plasma glucose levels are associated with worse outcomes in women with ovarian carcinoma, according to a report in the March 1st issue of Cancer.

"The results are only correlative but suggest a potential role for glycemic control medications and/or a low glycemic diet as adjuncts in the treatment of this disease," Donald M. Lamkin from the University of Iowa, Iowa City, Iowa, told Reuters Health.

Lamkin and colleagues examined the prognostic value of preoperative plasma glucose levels in 74 women with ovarian cancer.

Higher preoperative glucose levels were associated with significantly shorter survival time, the authors report. After adjustment for disease stage, each 70 mg/dL increase of glucose doubled the likelihood of death from ovarian cancer.

Similarly, each 70 mg/dL increase of glucose was associated with a 2.32-fold increase in the likelihood of disease recurrence after surgery.

"These findings are consistent with other studies that have shown an inverse relation between glucose levels and length of survival time in head and neck, stomach, and lung cancers and acute lymphocytic leukemia," the investigators say.

"Assuming we eventually do find a direct causal link between plasma glucose level and ovarian tumor growth, the important lesson may be that it really comes down to actual daily glycemic control, because, interestingly enough, neither formal diagnosis of diabetes nor being overweight had any significant association with cancer outcomes in this study," Lamkin said.

"Our collaborator, Dr. Douglas Spitz, has conducted experimental studies in mice that examine the effect of glucose antagonists on tumor growth in certain cancers," Lamkin added. "We are looking at conducting similar studies using ovarian cancer mouse models to test for a causal pathway between higher glucose and worse outcome."

"The rapid expansion of overlapping fields is opening up our understanding of the fundamental processes of life and growth, and it is also showing us how much we don't know," writes Dr. Richard T. Penson from Massachusetts General Hospital, Boston, in a related editorial. Rhetorically, he asks, "Could it be that cancer is more similar to normal tissue than we ever thought, and the same pressures on growth, more profoundly important than we ever feared?"

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