Hemoglobin A1c and the relationship to stage and grade of endometrial cancer.
OBJECTIVE
To determine if elevated markers of poor glycemic control (HgA1c and fasting glucose levels) in patients surgically staged for type I endometrial cancer is related to a higher stage or higher grade at the time of diagnosis. Also, to assess if these markers impact overall survival.


METHODS
A retrospective chart review was performed from January 2000 to June 2010 at three academic medical centers. Patients were included if they underwent surgical staging and had HgA1c drawn within 3 months before surgery. Demographic data, fasting blood glucose levels and overall survival data were also obtained.


RESULTS
Eighty-two patients fitting the inclusion criteria were identified during the study period. There was a strong positive correlation between HgA1c and fasting glucose. There was no statistical difference with regard to stage alone, grade alone, or when stratified together with regard to HgA1c or fasting glucose levels. There was a trend toward increased mean HgA1c across increasing stages, but this was not statistically significant. Diabetes, HgA1c and tumor grade did not affect overall survival, but advanced stage was a poor prognostic measure for overall survival.


CONCLUSIONS
Elevated preoperative HgA1c has a trend toward a higher stage at the time of diagnosis. Advanced stage is a poor prognostic measure for overall survival.
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, SUNY Downstate Medical Center, 450 Clarkson Ave, Box 24, Brooklyn, NY 11203, USA. erin.e.stevens@gmail.com
Erin E
EE
Stevens
Sarah
S
Yu
Melanie
M
Van Sise
Tana Shah
TS
Pradhan
Vanessa
V
Lee
Michael L
ML
Pearl
Yi-Chun
YC
Lee
Ovadia
O
Abulafia
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000378:metabolism*; D018269:Carcinoma, Endometrioid / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D003920:Diabetes Mellitus / Q000097:blood; D016889:Endometrial Neoplasms / Q000097:blood* / Q000473:pathology* / Q000601:surgery; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
D001786:Blood Glucose; D006442:Glycated Hemoglobin; C517652:hemoglobin A1c protein, human