Background: The aim of this study was to examine the impact of diabetes mellitus (DM) on survival in endometrial cancer patients, and the impact of endometrial cancer on glycemic control in DM.
Methods: Patients with newly diagnosed endometrial cancer with DM (n=48) were identified from the Institutional Cancer Registry and matched to 48 endometrial cancer patients without DM according to age, gender and year of cancer diagnosis (2006 to 2016). The electronic medical record provided information on DM, cancer therapies and laboratory results. Overall survival (OS) and progression-free survival (PFS) were estimated with the Kaplan-Meier method and compared by Cox regression analysis using stratification for matched pairs. Mixed models were used to compare hemoglobin A1c (HbA1c) and glucose during the year following cancer diagnosis.
Results: Mean age of the entire cohort was 67 years, 85% were white, and 76% had stage I disease. BMI was significantly different between DM and non-DM patients (39.6 versus 29.3; p<0.001). More patients without DM were treated with chemotherapy (33% versus 13%; p=0.04). Among those with DM, mean HbA1c during the year following cancer diagnosis was 7.2%. For glucose, DM group status was significant (p<0.001) as DM pts had higher glucose overall compared to non-DM pts (147 mg/dL vs. 106 mg/dL, p<0.001) and there was a time effect (p=0.03) as well. In both groups, glucose decreased during the year following diagnosis. Median follow-up time was 47 months (range 1.2 - 115.6 months) in living patients. 5-year survival estimated at 91% for DM patients versus 95% in non-DM pts by Kaplan Meier method (p=0.25 log rank test). OS Hazard ratio was 1.50 (95% CI: 0.25 - 8.98; p=0.66). 5-year PFS was estimated at 89% for both groups PFS Hazard ratio was 0.75 (95% CI: 0.17 -3.35; p=0.71).
Conclusions: Endometrial cancer and its treatment did not affect glycemic control. DM did not adversely impact survival in patients with endometrial cancer.
N. Karlin: None. P.M. Verona: None. M.R. Buras: None. H.E. Kosiorek: None. C. Cook: None.