Impact of Diabetes on Survival in Patients Undergoing Nephrectomy

A Danish study presented at the 2023 International Kidney Cancer Symposium: North America suggests that diabetes mellitus (DM) has a significant impact on overall survival (OS) in patients with renal cell carcinoma (RCC) who undergo nephrectomy.

Prior research has resulted in inconsistent findings regarding the relationship between DM and survival in patients with RCC who elect surgery.

Dr. Emma Heeno, of the Odense University Hospital, and colleagues sought to better understand the impact of DM on OS in patients with RCC who had undergone nephrectomy through an observational, retrospective, register-based cohort study. A total of 6198 patients with RCC who had a nephrectomy between 2000 and 2018 in Danish hospitals were included in the study.

Patients were identified from the Danish Cancer Registry and categorized based on presurgical DM (12.5%; n=774) and no presurgical DM (87.5%; n=5424).

Researchers investigated OS with Cox regression analysis.

Results of the analysis showed that patients with presurgical DM had lower OS (hazard ratio [HR], 1.36; P<.001). Among other significant variables associated with lower OS were male gender (HR, 1.11; P=.015) and age over 60 years (60-69 years: HR, 1.44; P<.001; 70-80 years: HR, 1.98; P<.001; over 80 years: HR, 2.86; P<.001).

Dr. Heeno and colleagues also found that tumor, node, and metastasis classification stages were statistically significant for poorer OS.

“This study indicates that DM has a significant impact on OS in patients with RCC who undergo nephrectomy, suggesting the need for differentiated treatment and monitoring,” they concluded. “Future studies should investigate both the combined and separate impact of DM and nephrectomy on OS, and explore alternative surgical techniques, conservative treatments, and additional outcome measures to optimize care for patients with DM.”