Abstract | PURPOSE: MATERIALS AND METHODS: We reviewed data on 3,075 consecutive patients treated with radical or partial nephrectomy for nonmetastatic renal cell carcinoma from 1988 to 2013. The propensity score of a diabetes mellitus history was calculated and 417 patients with diabetes were matched to 814 without diabetes in a 1:2 ratio. The potential association of preexisting diabetes and preoperative HbA1c with outcomes was tested. Univariate and multivariate analyses were performed to identify independent predictors of progression-free, cancer specific and overall survival. RESULTS: Before matching, patients with diabetes showed worse prognosis in terms of progression-free, overall and cancer specific survival (each p<0.001). In matched cohorts 1,231 patients with diabetes showed progression-free (p=0.001), cancer specific (p<0.001) and overall survival (p<0.001) inferior to that in patients without diabetes. On multivariate analyses diabetes was an independent predictor of disease progression (HR 1.766 p=0.002), all cause mortality (OR 1.825, p=0.001) and cancer specific mortality (HR 2.266, p=0.001). Among patients with diabetes who had available preoperative HbA1c data high HbA1c independently predicted postoperative disease progression (HR 2.221, p=0.023). CONCLUSIONS:
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Authors | Hakmin Lee, Cheol Kwak, Hyeon Hoe Kim, Seok-Soo Byun, Sang Eun Lee, Sung Kyu Hong |
Journal | The Journal of urology
(J Urol)
Vol. 194
Issue 6
Pg. 1554-60
(Dec 2015)
ISSN: 1527-3792 [Electronic] United States |
PMID | 26066406
(Publication Type: Clinical Study, Journal Article)
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Copyright | Copyright © 2015 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved. |
Chemical References |
- Glycated Hemoglobin A
- hemoglobin A1c protein, human
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Topics |
- Carcinoma, Renal Cell
(mortality, pathology, surgery)
- Cohort Studies
- Diabetes Complications
(mortality)
- Disease Progression
- Female
- Follow-Up Studies
- Glycated Hemoglobin
(metabolism)
- Humans
- Kaplan-Meier Estimate
- Kidney Neoplasms
(mortality, pathology, surgery)
- Male
- Middle Aged
- Multivariate Analysis
- Neoplasm Staging
- Nephrectomy
- Prognosis
- Propensity Score
- Risk Factors
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