Introduction:

Diabetes Mellitus (DM) has been hypothesized to be a risk factor for development of renal cell carcinoma (RCC). We evaluated impact of DM on survival outcomes in RCC.

Methods:

We performed a retrospective analysis of the International Marker Consortium for Renal Cancer (INMARC). The cohort was divided into three subgroups (patients with stage I vs. stage II vs. stage III RCC) for descriptive, survival and multivariable analysis of outcomes. Kaplan Meier Analysis (KMA) was used to compare diabetic and non-diabetic patients in the different stage subgroups to evaluate overall survival (OS), cancer-specific survival (CSS) and progression-free survival (PFS). Cox Regression multivariable analysis (MVA) was used to elucidate independent risk factors for all-cause mortality (ACM).  

Results:

2927 patients with stage I RCC (709-DM/ 2218 non-DM), 2513 with stage II RCC (688 DM/1825 non-DM) and 460 with stage 3 RCC (355 DM/ 105 non-DM) were analyzed. MVA revealed DMII having no impact on CSM (p=0.118) or PFS (p=0.316) across all stages. MVA for ACM revealed age (HR 1.026, p<0.001) , male sex (HR=1.425, p&lt;0.001), hypertension (HR=1.693, p <0.001) and tumor size (HR=1.064, p<0.001) as independent risk factors. KMA identified increased ACM in stage I (p<0.001) and stage III (p<0.001) RCC patients with non-DM compared to diabetic patients.

Conclusion:

Our findings suggest that DM may have impact on survival of in RCC, but this impact is mostly driven by non-oncologic, as opposed to oncologic effects.  Further investigation is requisite.  

Funding: Stephen Weissman Kidney Cancer Research Fund