TY - JOUR
T1 - Multi-institutional analysis of localized renal cell carcinoma that demonstrates the impact of diabetic status on prognosis after nephrectomy
AU - Ha, Yun Sok
AU - Kim, Won Tae
AU - Yun, Seok Joong
AU - Lee, Sang Cheol
AU - Kim, Wun Jae
AU - Park, Yong Hyun
AU - Kang, Seok Ho
AU - Hong, Sung Hoo
AU - Byun, Seok Soo
AU - Kim, Yong June
N1 - Funding Information:
ACKNOWLEDGMENT This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2011-0023308 and 2012-0000481).
PY - 2013/10
Y1 - 2013/10
N2 - Background: The purpose of our study was to determine whether preoperative diabetes mellitus (DM) can predict the prognosis of localized clear-cell renal cell carcinoma (RCC). Methods: At five institutes, 2,597 patients with pT1 and pT2 clear-cell RCC were enrolled. Univariate and multivariable analyses were performed to determine factors that associated with recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). To identify the effect of DM on survival after recurrence, a subgroup of 127 patients who had recurrences was analyzed. Results: In total, 357 patients had DM. Compared with patients without DM, these patients were older, more likely to be male, and had a higher body mass index, lower GFR, and higher incidence of hypertension. Kaplan-Meier curves showed that patients with DM had a significantly worse rate of RFS, CSS, and OS than patients without DM (log-rank test, all P < 0.05). Multivariate analysis revealed that DM was an independent prognostic factor in terms of RFS, CSS, and OS. In the subgroup analysis of 127 patients with recurrence, DM was associated with a lower survival rate after the initial recurrence. Conclusions: DM appeared to be an important determinant of prognosis in clear-cell localized RCC, especially in patients experiencing recurrence.
AB - Background: The purpose of our study was to determine whether preoperative diabetes mellitus (DM) can predict the prognosis of localized clear-cell renal cell carcinoma (RCC). Methods: At five institutes, 2,597 patients with pT1 and pT2 clear-cell RCC were enrolled. Univariate and multivariable analyses were performed to determine factors that associated with recurrence-free survival (RFS), cancer-specific survival (CSS), and overall survival (OS). To identify the effect of DM on survival after recurrence, a subgroup of 127 patients who had recurrences was analyzed. Results: In total, 357 patients had DM. Compared with patients without DM, these patients were older, more likely to be male, and had a higher body mass index, lower GFR, and higher incidence of hypertension. Kaplan-Meier curves showed that patients with DM had a significantly worse rate of RFS, CSS, and OS than patients without DM (log-rank test, all P < 0.05). Multivariate analysis revealed that DM was an independent prognostic factor in terms of RFS, CSS, and OS. In the subgroup analysis of 127 patients with recurrence, DM was associated with a lower survival rate after the initial recurrence. Conclusions: DM appeared to be an important determinant of prognosis in clear-cell localized RCC, especially in patients experiencing recurrence.
UR - http://www.scopus.com/inward/record.url?scp=84883758845&partnerID=8YFLogxK
U2 - 10.1245/s10434-013-3147-7
DO - 10.1245/s10434-013-3147-7
M3 - Article
C2 - 23907313
AN - SCOPUS:84883758845
SN - 1068-9265
VL - 20
SP - 3662
EP - 3668
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
IS - 11
ER -
