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KMID : 1137020160270030028
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Journal of Gynecologic Oncology
2016 Volume.27 No. 3 p.28 ~ p.28
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Impact of diabetes mellitus on oncological outcomes after radical hysterectomy for early stage cervical cancer
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Jiamset Ingporn
Hanprasertpong Jitti
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Abstract
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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.
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KEYWORD
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Diabetes Mellitus, Hysterectomy, Metformin, Prognosis, Uterine Cervical Neoplasms
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