Multivariate Analysis on the Effects of Diabetes and related Clinical Parameters on Cervical Cancer Survival Probability

Abstract

We aimed to evaluate and determine the effect of diabetes mellitus (DM) on overall survival (OS) and cancer-specific survival (CSS) in early stage cervical cancer (CC) patients. Patients with primary cervical cancer and newly diagnosed were selected from ten different cancer specialist hospitals of Malaysia. Patients' demographic and clinical data were obtained for the prognostic analysis. Kaplan-Meier method was used to estimate patients' survival time (CSS and OS) with DM status and values were compared using the log-rank test. A total of 19,785 newly diagnosed CC patients were registered during 2010-2016, among them only 16,946 (85.6%) with primary CC tumor. There was no difference in treatment modality between DM and non-DM patients. However intergroup assessment showed that type 2DM have significantly higher rate of mortality in both overall mortality (28.3%) and CC-specific (11.7%) as compared to Type 1DM (17.3%; 5.5%) and non DM patients (12.7%; 9.1%) (p < 0.001). Within group assessments showed that Type 2DM patients have better quality of life (mean 7.13 ± 3.67) (p < 0.001) and less distress levels (mean 2.41 ± 0.63) (p < 0.011) as compared to type1 DM (meant 10.54 ± 2.11; 3.19 ± 1.07). This study concluded that T2DM prognostic effect still remained after adjusting demographic and clinical parameters. Type 1 diabetes mellitus showed better OS and CSS then type2 DM.