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• W2040595630 abstract "No AccessJournal of UrologyAdult Urology1 Dec 2014Diabetes Mellitus is Independently Associated with an Increased Risk of Mortality in Patients with Clear Cell Renal Cell Carcinoma Sarah P. Psutka, Suzanne B. Stewart, Stephen A. Boorjian, Christine M. Lohse, Matthew K. Tollefson, John C. Cheville, Bradley C. Leibovich, and R. Houston Thompson Sarah P. PsutkaSarah P. Psutka Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Suzanne B. StewartSuzanne B. Stewart Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Stephen A. BoorjianStephen A. Boorjian Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , Christine M. LohseChristine M. Lohse Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota More articles by this author , Matthew K. TollefsonMatthew K. Tollefson Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , John C. ChevilleJohn C. Cheville Department of Pathology, Mayo Clinic, Rochester, Minnesota More articles by this author , Bradley C. LeibovichBradley C. Leibovich Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author , and R. Houston ThompsonR. Houston Thompson Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2014.06.014AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Conflicting data exist on the interaction of diabetes mellitus with outcomes in patients with renal cell carcinoma. We evaluated the association of diabetes mellitus with survival in patients with clear cell renal cell carcinoma treated with nephrectomy. Materials and Methods: We reviewed the records of 1,964 patients treated surgically for sporadic, unilateral, M0 clear cell renal cell carcinoma between 1990 and 2008. One pathologist re-reviewed all specimens to confirm clear cell renal cell carcinoma. We matched 257 patients with diabetes 1:2 to referent patients without diabetes according to clinicopathological and surgical features. Cancer specific and overall survival was estimated using the Kaplan-Meier method. Cox models were used to evaluate associations with outcomes. Results: A total of 257 patients (13%) had diabetes mellitus. They were significantly older and more likely to be obese, and had higher Charlson scores, renal impairment and smoking rates, and worse performance status at surgery (p <0.001). Pathological features were similar between the groups. Median postoperative followup was 8.7 years. Five-year cancer specific survival was similar in patients with and without diabetes (82% vs 86%, p = 0.1) while 5-year overall survival was significantly worse in those with diabetes (65% vs 74%, p <0.001). On multivariable analysis diabetes mellitus independently predicted cancer specific mortality (HR 1.55, 95% CI 1.08–2.21, p = 0.02) and all-cause mortality (HR 1.32, 95% CI 1.06–1.64, p = 0.01). Conclusions: Our results suggest that diabetes mellitus is independently associated with decreased cancer specific and overall survival in patients with surgically treated clear cell renal cell carcinoma. References 1 Cancer Facts and Figures 2013. Atlanta: American Cancer Society2013. Google Scholar 2 : Environmental and modifiable risk factors in renal cell carcinoma. Urol Oncol2012; 30: 220. Google Scholar 3 : Contemporary epidemiology of renal cell carcinoma: perspectives of primary prevention. World J Urol2010; 28: 247. 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Google Scholar 28 : UOK 262 cell line, fumarate hydratase deficient (FH-/FH-) hereditary leiomyomatosis renal cell carcinoma: in vitro and in vivo model of an aberrant energy metabolic pathway in human cancer. Cancer Genet Cytogenet2010; 196: 45. Google Scholar 29 : Aerobic glycolysis: a novel target in kidney cancer. Expert Rev Anticancer Ther2013; 13: 711. Google Scholar 30 : Matching in epidemiologic studies: validity and efficiency considerations. Biometrics1981; 37: 271. Google Scholar © 2014 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byLee H, Kwak C, Kim H, Byun S, Lee S and Hong S (2018) Diabetes Mellitus as an Independent Predictor of Survival of Patients Surgically Treated for Renal Cell Carcinoma: A Propensity Score Matching StudyJournal of Urology, VOL. 194, NO. 6, (1554-1560), Online publication date: 1-Dec-2015. Volume 192Issue 6December 2014Page: 1620-1627Supplementary Materials Advertisement Copyright & Permissions© 2014 by American Urological Association Education and Research, Inc.Keywordscarcinomakidneymortalitydiabetes mellitusnephrectomyrenal cellMetricsAuthor Information Sarah P. Psutka Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Suzanne B. Stewart Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Stephen A. Boorjian Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Christine M. Lohse Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota More articles by this author Matthew K. Tollefson Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author John C. Cheville Department of Pathology, Mayo Clinic, Rochester, Minnesota More articles by this author Bradley C. Leibovich Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author R. Houston Thompson Department of Urology, Mayo Clinic, Rochester, Minnesota More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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