Prevalence of type 2 diabetes diagnoses in the perioperative and survivorship periods following surgical management of endometrial cancer: An opportunity for screening and intervention?

Objective: To determine the prevalence of Type 2 diabetes mellitus (T2DM) diagnoses during the peri-operative and survivorship periods in patients following surgical management of endometrial cancer (EC).
Methods: An IRB-approved, retrospective single-institution cohort study was performed in patients who underwent surgical management of EC from 2014 to 2020. The perioperative period was defined as the 30 days before and after surgery. T2DM diagnoses occurring during survivorship were recorded. T2DM diagnoses were defined by a HgbA1c ≥6.5% or a random blood glucose ≥200 mg/dL. Sequelae of peri-operative T2DM and predictors of future T2DM were examined utilizing univariate analysis.
Results: Of 519 patients meeting inclusion criteria, 37 (7.1%) were diagnosed with T2DM in the perioperative period. Patients diagnosed with T2DM in the perioperative period had significantly higher BMI (p = 0.006) compared to no T2DM, but there were no significant differences in age (p = 0.20), ethnicity/race (p > 0.05) or ECOG score (p = 0.19). The rates of intraoperative complications between groups did not significantly differ, except for vascular complications (p = 0.005), and the incidence of any postoperative complication was higher in the perioperative T2DM group (p = 0.01). With a median follow-up of 29 months [range 11.6-49.0 months], an additional 18.3% (n = 88) of the cohort met diagnostic criteria for T2DM. BMI (p < 0.001), perioperative glucose (p < 0.001), and HgbA1c (p = 0.002) demonstrate risk for a T2DM diagnosis during survivorship.
Conclusion(s): In this retrospective cohort of EC patients, 25.4% were diagnosed with T2DM, with the majority diagnosed in the survivorship period. Surgical management and subsequent surveillance of EC presents an opportunity to diagnose at-risk patients with T2DM.
Competing Interests: Conflict of interest statement C.M.C. has received funds from AstraZeneca and GlaxoSmithKline. D.O.M. receives institutional research funding from AbbVie, Agenus, Aravive, AstraZeneca, Boston Biomedical, Clovis Oncology, Eisai, Exelixis, Genmab, GOG Foundation, ImmunoGen, IOVANCE Biotherapeutics, Leap Therapeutics, Merck, Mersana Therapeutics, NRG Oncology, OncoQuest, Precision Therapeutics, Regeneron Pharmaceuticals, Rubuis Therapeutics, Sutro Biopharma, TESARO, Advaxis, Alkermes, Arcus Biosciences, BeiGene, Bristol Myers Squibb, Deciphera Pharma, EMB Serono, Genentech, GlaxoSmithKline, Hoffman-La Roche, Incyte Corporation, Karyopharm, Ludwig Institute, Merck Sharp & Dohme Corp, NCI, NovoCure, OncoC4 Inc., Pfizer Inc., Prelude Therapeutics, RTOG, Seattle Genetics (SeaGen), SWOG, and Verastem Inc. L.Copeland reports personal fees from Celsion Corporation, personal fees and other from Corcept Therapeutics, Inc., personal fees from Elevar Therapeutics, grants and personal fees from GSK, Inc., personal fees from Myriad Genetics, Inc., personal fees from Rubius Therapeutics, personal fees from Sorrento Therapeutics, personal fees from Tarveda Therapeutics, personal fees from Toray Industries, Inc., grants from Abbvie, grants from Advaxis, grants from Agenus, grants from Ajinomoto, grants from Array BioPharm, grants from AstraZeneca, grants from Bristol Myers Squbb, grants from Clovis Oncology, grants from Deciphera Parma, grants from Eisai, grants from EMD Serono Inc., grants from ERGOMED Clinical Research, grants from Exelixis, grants from Genentech/Roche, grants from Genmab, grants from Hoffman-LaRoche, grants and personal fees from Immunogen, grants from Incyte Corporation, grants from Iovance Biotherapeutics, grants from InVentive Health Clinical, grants from Jansen R&D, grants from Leap Therapeutics, grants from Ludwig Institute for Pharmaceuticals, grants from Merck, grants from Mersana Therapeutics, Inc., grants from Novocure, grants from Novartis Pharmaceuticals, grants from OncoQuest, grants from PRA International, grants from Regeneron Pharnaceuticals, grants from Seattle Genetics, grants from Serono, grants from Sutro Biopharm, grants from Tesaro (GSK), grants from Arcus Biosciences, Inc., grants from Sumitomo Dainippon Pharma Oncolgy, grants from Cerulean Pharma, grants from Karyopharm, grants from BeiGene USA, Inc., grants from Ovagene, grants from Pfizer Inc., grants from Pharma Mar USA, Inc., grants from Precision Therapeutics, Inc., grants from Sanofi, grants from Stemcentrx, Inc., grants from TRACON Pharm, grants from Verastem, Inc., personal fees from VBL Therapeutics, Inc., personal fees from OncoNova, Inc., personal fees from Inx Med, personal fees from Luzsana Biotechnology, outside the submitted work; .D.O.M. receives consulting fees from AbbVie, Adaptimmune, Agenus Inc., Arquer Diagnostics, Arcus Biosciences Inc., AstraZeneca, Atossa Therapeutics, Boston Biomedical, Cardiff Oncology, Celcuity, Clovis Oncology, Corcept Therapeutics, Duality Bio, Eisai, Elevar, Exelixis, Genentech Inc., Genelux, GlaxoSmithKline, GOG Foundation, Hoffman-La Roche Inc., ImmunoGen Inc., Imvax, InterVenn, INXMED, IOVANCE Biotherapeutics, Janssen, Jazz Pharmaceuticals, Laekna, Leap Therapeutics Inc., Luzsana Biotechnology, Merck & Co, Merck Sharp & Dohme Corp, Mersana Therapeutics Inc., Myriad, Novartis, NovoCure, OncoC4 Inc., Onconova, Regeneron Pharmaceuticals Inc., Repimmune, R Pharm, Roche Diagnostics, Seattle Genetics (SeaGen), Sorrento, Sutro Biopharma, Tarveda Therapeutics, Toray, Trillium, Umoja, Verastem Inc., VBL Therapeutics, Vincerx Pharma, Xencor, and Zentalis. No research or consulting funding was utilized in the execution or formulation of this study.
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