Survival outcomes in endometrial cancer patients according to diabetes: a systematic review and meta-analysis

Abstract

Background Diabetes is an established risk factor for endometrial cancer development but its impact on prognosis is unclear and epidemiological studies to date have produced inconsistent results. We aimed to conduct the first systematic review and meta-analysis to compare survival outcomes in endometrial cancer patients with and without pre-existing diabetes. Methods We conducted a systematic search of MEDLINE, EMBASE and Web of Science databases up to February 2022 for observational studies that investigated the association between pre-existing diabetes and cancer-specific survival in endometrial cancer patients. Secondary outcomes included overall survival and progression or recurrence-free survival. Quality assessment of included studies was undertaken using the Newcastle–Ottawa Scale and a random-effects model was used to produce pooled hazard ratios (HRs) and 95% confidence intervals (CIs). (PROSPERO 2020 CRD42020196088). Results In total, 31 studies were identified comprising 55,475 endometrial cancer patients. Pooled results suggested a worse cancer-specific survival in patients with compared to patients without diabetes (n = 17 studies, HR 1.15, 95% CI 1.00–1.32, I2 = 62%). Similar results were observed for progression or recurrence-free survival (n = 6 studies, HR 1.23, 95% CI 1.02–1.47, I2 = 0%) and for overall survival (n = 24 studies, HR 1.42, 95% CI 1.31–1.54, I2 = 46%). Conclusion In this systematic review and meta-analysis, we show that diabetes is associated with a worse cancer-specific and overall survival in endometrial cancer patients.

Pyroptosis: the dawn of a new era in endometrial cancer treatment

“…Socioeconomic, racial disparities and geographic differences largely determine incidence and mortality of EC ( 1 , 3 ). The high prevalence of EC is associated with several risk factors, including population aging, exposure to endogenous or exogenous hormones, high body mass index (BMI), metabolic syndrome and epigenetic alterations ( 3 , 4 ).…”

Metabolic Syndrome and Survival Outcomes in Endometrial Cancer

“…Furthermore, diabetic patients associated a significantly higher HR of 1.23 (95% CI: 1.02-1.47, I² = 0%) for disease recurrence or progression. Additionally, a statistically significant association was observed between diabetes and a poorer OS rate (HR: 1.42, 95% CI: 1.31-1.54, I² = 46%) [58].…”

Diabetes mellitus and the female reproductive system tumors

“…Другой систематический обзор был посвящен сравнению выживаемости пациенток с раком эндометрия, у которых на момент постановки онкологического диагноза был СД, с теми, у кого не было СД. Результаты показали, что наличие СД связано с более низкой общей выживаемостью, но не с выживаемостью без заболевания, безрецидивной выживаемостью или выживаемостью без прогрессирования [ 47 ]…”