title: Prognostic significance of diabetes mellitus in localized renal cell carcinoma.
abstract: OBJECTIVE
  We investigated whether diabetes mellitus is associated with the cancer-related outcomes in patients with localized clear cell renal cell carcinoma treated with radical or partial nephrectomy.
  
  
  METHODS
  We reviewed data from 950 patients who received radical or partial nephrectomy for localized clear cell renal cell carcinoma from 1988 to 2009. We analyzed potential association of patients' diabetic status and various clinicopathologic features. Univariate and multivariate analyses were performed to identify independent predictors of cancer-specific survival, overall survival and non-cancer-related survival.
  
  
  RESULTS
  Of 950 patients, 108 (11.4%) reported having diabetes mellitus pre-operatively. Patients with and without diabetes mellitus demonstrated no significant differences regarding various clinicopathologic features except for age (P < 0.001), pre-existing hypertension (P < 0.001), pre-existing cardiovascular disease (P < 0.001) and performance status (P = 0.019). In terms of cancer-specific, overall and non-cancer-related survival, the Kaplan-Meier curves showed that non-diabetic patients had superior survival rates than diabetics (P = 0.012, <0.001 and <0.001, respectively). Meanwhile, although diabetes mellitus was shown to be an independent predictor of overall survival (P = 0.022) and non-cancer-related survival (P = 0.034), it was not observed to be a significant predictor of cancer-specific survival (P = 0.234) in multivariate analyses.
  
  
  CONCLUSIONS
  Diabetes mellitus may not be directly associated with disease-specific outcome in patients who receive surgical management for localized renal cell carcinoma. However, since diabetes mellitus was observed to be associated with overall survival in such patients, diabetic patients undergoing surgery for localized renal cell carcinoma should be counseled on the potential impact of diabetes mellitus.  Institutional review board (IRB) approval number H-1106-062-366.
authors.affiliation: Department of Urology, Seoul National University Bundang Hospital, 300, Gumi-dong, Bundang-gu, Seongnam-si, Gyunggi-do 463-707, Republic of Korea.
authors.forename: Sangchul
authors.initials: S
authors.lastname: Lee
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Hong
authors.forename: Cheol
authors.initials: C
authors.lastname: Kwak
authors.forename: Hyeon Hoe
authors.initials: HH
authors.lastname: Kim
authors.forename: Sang Eun
authors.initials: SE
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002292:Carcinoma, Renal Cell / Q000150:complications* / Q000401:mortality / Q000601:surgery; D003920:Diabetes Mellitus / Q000401:mortality*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009392:Nephrectomy; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome