Pre‐existing type 2 diabetes is an adverse prognostic factor in patients with renal cell carcinoma

Abstract

Background Diabetes is a risk factor for various cancers, but its prognostic role in renal cell carcinoma (RCC) is controversial and understudied. This study investigated the prognostic value of type 2 diabetes (T2D) in RCC patients. Methods The clinicopathological and follow‐up data of 451 RCC patients undergoing radical or partial nephrectomy at the First Hospital of Shanxi Medical University from 2013 to 2018 were reviewed. Associations of T2D with clinicopathological parameters of RCC were evaluated using the Kaplan‐Meier method for survival estimates and Cox regression univariate and multivariate analyses. Results Of 451 patients, 74 (16.4%) had T2D. These patients were older, had a higher body mass index, higher incidence rates of hypertension and cardiovascular morbidity, a higher rate of laparoscopic surgery, and smaller neoplasms (all P < .05). Patients with T2D exhibited shorter overall survival (OS; P = .009), cancer‐specific survival (CSS; P = .043), and recurrence‐free survival (RFS; P = .008) than patients without T2D. Fuhrman grade (hazard ratio [HR] 2.542, 95% confidence interval [CI] 1.115‐5.795, P = .026) and T2D (HR 3.391, CI 1.458‐7.886, P = .005) were independent predictors of OS; T2D was an independent predictor of CSS (HR = 4.637, 95% CI 1.420‐15.139, P = .011) and RFS (HR 3.492, 95% CI 1.516‐8.044, P = .003). Conclusions Renal cell carcinoma patients with T2D have a shorter OS and higher recurrence rate and mortality risk than those without T2D.

Metabolic Syndrome Predicts Worse Perioperative Outcomes in Patients Treated With Partial Nephrectomy for Renal Cell Carcinoma

“…Finally, no meaningful differences were observed in subgroup analyses according to open vs. laparoscopic/robotic PN approach. Our findings build upon previous reports, where individual MetS components have been examined, but were never tested after full adjustment for the effect of the remaining MetS components 10,[13][14][15]21,[23][24][25] . To the best of our knowledge, we are the first to demonstrate the individual ability of each MetS component, even when all others components are fully accounted for.…”

“…The association between MetS and early adverse perioperative outcomes after PN has been poorly investigated [5][6][7][8][9] . However, obesity 10,[12][13][14][15]17 , hypertension 20,21 and diabetes 21,[23][24][25] have been previously related to higher complication rates after PN. These analyses did not account for the simultaneous effect of other MetS components.…”

“…However, there are no robust data to indicate whether or not MetS predicts early adverse outcomes after partial nephrectomy (PN) [5][6][7][8][9] . Nonetheless, several previous reports examined the effect of individual MetS components, namely either obesity [10][11][12][13][14][15][16][17][18] or hypertension [19][20][21] or diabetes [21][22][23][24][25] , on perioperative outcomes after PN, without adjusting for possible combined effect of other MetS components. Moreover, none of previous studies addressed the possible synergistic effect of multiple MetS components on perioperative complications after PN.…”

<p>Development and Validation of a Nomogram Predicting the Prognosis of Renal Cell Carcinoma After Nephrectomy</p>

“…In addition, high levels of insulin and IGF-1 will also increase the secretion of vascular endothelial growth factor (VEGF), up-regulate the expression of VEGF, induce tumor neovascularization, and promote the occurrence and metastasis of tumor, which would lead to poor prognosis of patients with RCC. [24][25][26] In recent years, in addition to using a nomogram to develop models for predicting the survival time of RCC patients after an operation, some researchers have also developed models for predicting the OS, CSS, RFS and disease-free survival (DFS) of RCC patients undergoing nephrectomy. [27][28][29][30][31][32][33][34] Based on the survival rate of RCC patients undergoing nephrectomy, scoring systems were To some extent, the nomogram developed by us is helpful to find out the RCC patients with poor OS in time to give them more attention and even timely intervention after operation, so as to prolong their OS.…”

System biology approaches identified novel biomarkers and their signaling pathways involved in renal cell carcinoma with different human diseases

“…Because hypertension and OB are major RCC health issues closely associated with T2D, taking these factors into account when assessing the link between T2D and RCC is crucial [ 3 ]. T2D was linked to a higher risk of RCC [ 26 ].…”