title: Management of comorbidities in diabetics with renal cell carcinoma: past utilization and current outcomes.
abstract: OBJECTIVE
  This study evaluated whether particular diabetes mellitus (DM), hyperlipidemia, or hypertension pharmacotherapy was associated with improved renal cell carcinoma (RCC) outcomes in diabetics with emergent RCC.
  
  
  METHODS
  All DM cases newly diagnosed with RCC at Roswell Park Cancer Institute (January 01, 2003-December 31, 2010) were included (n = 95). Baseline demographic information, clinical history, and cancer outcomes were documented after chart review. Fisher's test was used for the analysis of categorical outcomes across different treatment groups. Univariate and multivariate analyses for the comparisons of the overall survival and progression-free survival across treatment groups were assessed using Kaplan-Meier log-rank test and Cox proportional hazards models.
  
  
  RESULTS
  We found that DM pharmacotherapy users, which may represent a more advanced disease as compared to those controlled by diet alone, displayed significantly greater mortality (P = .01). Additionally, we found that cholesterol-lowering pharmacotherapy use was associated with decreased RCC mortality (hazard ratio = 0.54, P = .06). Individuals receiving combined hypertension regimens had a lower chance to present with baseline metastasis; however, hypertension pharmacotherapy use added no survival benefit.
  
  
  CONCLUSIONS
  Reinforcing guidelines compliance for hyperlipidemia management in patients with DM may provide a considerable cancer benefit if diagnosed with RCC. Studies evaluating the need for cholesterol-lowering pharmacotherapy in guidelines-noncompliant DM cases upon RCC diagnosis are currently needed.
authors: State University of New York (SUNY) at Buffalo, Department of Pharmacy Practice, Buffalo, NY, USA.
authors: Jonathan L
authors: JL
authors: Rabey
authors: Jingjing
authors: J
authors: Yin
authors: Tammy M
authors: TM
authors: Kublas
authors: Terry
authors: T
authors: Mashtare
authors: Alice C
authors: AC
authors: Ceacareanu
mesh_terms: D000368:Aged; D000924:Anticholesteremic Agents / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002292:Carcinoma, Renal Cell / Q000473:pathology*; D015331:Cohort Studies; D003920:Diabetes Mellitus / Q000188:drug therapy* / Q000503:physiopathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000188:drug therapy* / Q000503:physiopathology; D006973:Hypertension / Q000188:drug therapy* / Q000503:physiopathology; D053208:Kaplan-Meier Estimate; D007680:Kidney Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents
keywords: diabetes mellitus; hyperlipidemia; hypertension; pharmacotherapy; renal cell carcinoma outcomes