Also available in: Español
Rev Mex Urol. 2018 January-February;78(1):1-7. DOI: https://doi.org/10.24245/revmexurol.v78i1.1458
Uscanga-Yépez J,1 González-Oyervides R,1 Olvera-Posada D,2 Góngora-Cortéz JJ,3 Barrera Juárez E2
1 Department of Urology, Hospital Metropolitano Dr. Bernardo Sepúlveda, Nuevo León, Mexico. National School of Medicine, Department of Urology, Instituto Tecnológico de Estudios Superiores de Monterrey.
2 Department of Urology, Centro Médico Zambrano Hellion, Instituto de Cirugía. National School of Medicine, Department of Urology, Instituto Tecnológico de Estudios Superiores de Monterrey.
3 Department of Evaluation and Statistics, National School of Medicine, Instituto Tecnológico de Estudios Superiores de Monterrey.
OBJECTIVE: To evaluate the influence of type 2 diabetes mellitus on the TNM staging classification in patients with renal cell carcinoma treated through nephrectomy.
MATERIALS AND METHODS: A retrospective, cross-sectional, descriptive study was conducted. The case records were reviewed of patients with sporadic and unilateral renal cell carcinoma that underwent nephrectomy at the Urology Department of the Hospital Metropolitano Dr. Bernardo Sepúlveda (SSA), within the time frame of 2008 and 2014. According to their preoperative status, the patients were classified as presenting with or without type 2 diabetes mellitus. The demographic and clinical variables analyzed were: age, sex, pathologic tumor size, and type of surgery (radical or partial). The comorbidities evaluated were high blood pressure, type 2 diabetes mellitus, dyslipidemia, and smoking. The pathologic findings assessed were: staging (including tumor size) according to the 2009 TNM classification proposed by the American Joint Committee on Cancer (AJCC), Fuhrman grade, and the histologic type reviewed by two pathologists from the Department of Pathology. Each TNM classification result was analyzed independently through the χ2 test. Overall survival and recurrence-free survival were evaluated through the Kaplan-Meier test.
RESULTS: A total of 18.6% of the study patients presented with type 2 diabetes mellitus. According to the TNM classification, T1b tumors predominated in 32.6% of the cases. No statistically significant differences were found in the comparison of pathologic tumor stage (p = 0.5), lymph node disease (p = 0.7), or metastasis (p = 0.5) between patients with type 2 diabetes mellitus and those without the disease. Median follow-up was 45 months and no differences were found in the comparison of overall survival and recurrence-free survival in the patients with type 2 diabetes mellitus (p = 0.76) and those without the pathology (p = 0.78).
CONCLUSIONS: Type 2 diabetes mellitus had no significant impact on the pathologic stage of renal cell carcinoma or on overall survival and recurrence-free survival in those patients.
KEYWORDS: Renal cell carcinoma; TNM classification; Nephrectomy; Type 2 diabetes mellitus.
Dr. Jaime Uscanga Yépez