Impact of diabetes mellitus on oncological outcomes after radical hysterectomy for early stage cervical cancer

Abstract

ObjectiveTo evaluate the relationship between type 2 diabetes mellitus (DM) and oncological outcomes in early stage cervical cancer patients who underwent radical surgical resection.MethodsPatients 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.ResultsPatients 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.ConclusionEarly stage cervical cancer patients with type 2 DM have a poorer oncological outcome than patients without DM.

Linking type 2 diabetes and gynecological cancer: an introductory overview

“…Early stage CC patients with type 2 DM have a poorer oncological outcome than patients without DM [95]. These concepts are summarized in Figure 3.…”

The association between diabetes/hyperglycemia and the prognosis of cervical cancer patients

“…[ 12 – 16 ] Considering the prognostic roles of diabetes, numerous studies also have investigated its predictive role in cervical cancer prognosis. [ 17 – 26 ] Some studies reported that diabetes was associated with poor survival in cervical cancer patients, [ 17 , 24 , 25 ] but others indicated that diabetes had no significant influence on the prognosis of cervical cancer. [ 20 , 27 ] Therefore, the role of diabetes in predicting the prognosis of cervical cancer is still controversial.…”

Assessing Factors Associated With Survival Among Cervical Cancer Patients in Kenya: A Retrospective Follow-up Study

“…Other studies that have shown that type 2 diabetes resulted in poor oncological outcomes in patients with early stage cervical cancer. 36,37 These proposed associations were not reflected in this study, which could be the result of both low overall prevalence of NCD comorbidity in the study population and a small number of patients undergoing or completing chemoradiation.…”