Impact of diabetes mellitus on oncological outcomes after radical hysterectomy for early stage cervical cancer.
- Author:
Ingporn JIAMSET
1
;
Jitti HANPRASERTPONG
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Diabetes Mellitus; Hysterectomy; Metformin; Prognosis; Uterine Cervical Neoplasms
- MeSH: Adult; Age Factors; Diabetes Mellitus, Type 2/*complications/drug therapy; Female; Humans; Hypoglycemic Agents/therapeutic use; *Hysterectomy; Metformin/therapeutic use; Middle Aged; Prognosis; Proportional Hazards Models; Retrospective Studies; Survival Analysis; Uterine Cervical Neoplasms/*complications/diagnosis/surgery
- From:Journal of Gynecologic Oncology 2016;27(3):e28-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: To evaluate the relationship between type 2 diabetes mellitus (DM) and oncological outcomes in early stage cervical cancer patients who underwent radical surgical resection. METHODS: Patients with early stage cervical cancer diagnosed between 2001 and 2014 were retrospectively enrolled. We assessed the outcomes of 402 non-DM and 42 DM patients with cervical cancer. We tested the prognostic value of DM via Cox proportional hazard modeling. RESULTS: Patients with DM were more likely to be older and overweight. In the DM group, 20 and 22 patients were and were not taking metformin, respectively. The 5-year recurrence-free survival (RFS) and 5-year overall survival (OS) rate for the whole study population were 88.49% and 96.34%, respectively. In the DM group, there was no evidence that metformin affected the RFS (p=0.553) or the OS (p=0.429). In multivariate analysis, age (p=0.007), histology (p=0.006), and deep stromal invasion (p=0.007) were independent adverse prognostic factors for RFS. There was a borderline significant association of increased RFS with DM (p=0.051). However, a time-varying-effect Cox model revealed that the DM was associated with a worse RFS (hazard ratio, 11.15; 95% CI, 2.00 to 62.08, p=0.022) after 5 years. DM (p=0.008), age (p=0.009), and node status (p=0.001) were the only 3 independent prognostic factors for OS. CONCLUSION: Early stage cervical cancer patients with type 2 DM have a poorer oncological outcome than patients without DM.
