Njoku Kelechi, Agnew Heather J, Crosbie Emma J
Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, St Mary's Hospital, University of Manchester, Manchester, United Kingdom.
Stoller Biomarker Discovery Centre, Institute of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
Front Oncol. 2022 May 5;12:899262. doi: 10.3389/fonc.2022.899262. eCollection 2022.
Type 2 diabetes mellitus (T2DM) is an established risk factor for endometrial cancer but its impact on endometrial cancer survival outcomes is unclear. The aim of this study was to investigate whether pre-existing T2DM impacts survival outcomes in endometrial cancer.
Women diagnosed with endometrial cancer were recruited to a single centre prospective cohort study. Relevant sociodemographic and clinico-pathological data were recorded at baseline. T2DM status was based on clinical and biochemical assessment, verified by general practitioner records and analysed in relation to overall, cancer-specific and recurrence-free survival using Kaplan-Meier estimation and multivariable Cox-regression.
In total, 533 women with median age and BMI of 66 years (Interquartile range (IQR), 56, 73) and 32kg/m (IQR 26, 39) respectively, were included in the analysis. The majority had low-grade (67.3%), early-stage (85.1% stage I/II), endometrial cancer of endometrioid histological phenotype (74.7%). A total of 107 (20.1%) had pre-existing T2DM. Women with T2DM had a two-fold increase in overall mortality (adjusted HR 2.07, 95%CI 1.21-3.55, p=0.008), cancer-specific mortality (adjusted HR 2.15, 95% CI 1.05-4.39, p=0.035) and recurrence rates (adjusted HR 2.22, 95% CI 1.08-4.56, p=0.030), compared to those without, in multivariable analyses.
T2DM confers an increased risk of death in endometrial cancer patients. Well-designed longitudinal studies with large sample sizes are now needed to confirm these findings.
2型糖尿病（T2DM）是子宫内膜癌已确定的危险因素，但其对子宫内膜癌生存结局的影响尚不清楚。本研究的目的是调查既往存在的T2DM是否会影响子宫内膜癌的生存结局。
招募被诊断为子宫内膜癌的女性参与一项单中心前瞻性队列研究。在基线时记录相关的社会人口统计学和临床病理数据。T2DM状态基于临床和生化评估，经全科医生记录核实，并使用Kaplan-Meier估计法和多变量Cox回归分析其与总生存、癌症特异性生存和无复发生存的关系。
分析共纳入533名女性，年龄中位数和体重指数（BMI）分别为66岁（四分位间距（IQR），56，73）和32kg/m²（IQR 26，39）。大多数患者为低级别（67.3%）、早期（85.1%为I/II期）、子宫内膜样组织学表型的子宫内膜癌（74.7%）。共有107名（20.1%）患者既往存在T2DM。在多变量分析中，与无T2DM的女性相比，有T2DM的女性总死亡率增加两倍（调整后风险比（HR）2.07，95%置信区间（CI）1.21 - 3.55，p = 0.008），癌症特异性死亡率（调整后HR 2.15，95% CI 1.05 - 4.39，p = 0.035）和复发率（调整后HR 2.22，95% CI 1.08 - 4.56，p = 0.030）。
T2DM会增加子宫内膜癌患者的死亡风险。现在需要设计良好且样本量较大的纵向研究来证实这些发现。
