Type 2 diabetes mellitus predicts worse outcomes in patients with high-grade T1 bladder cancer receiving bacillus Calmette-Guérin after transurethral resection of the bladder tumor.

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RESEARCH PRODUCT

Type 2 diabetes mellitus predicts worse outcomes in patients with high-grade T1 bladder cancer receiving bacillus Calmette-Guérin after transurethral resection of the bladder tumor.

Vincenzo Serretta Angelo Porreca Matteo Ferro Francesco Del Giudice Gian Maria Busetto Raluca Marian Giorgio Ivan Russo Michele Battaglia Pasquale Ditonno Rodolfo Hurle Gennaro Musi Abdal Rahman Abu Farhan Estevão Lima Vincenzo Mirone Savino M. Di Stasi Guru Sonpavde Carlo Buonerba Pierluigi Bove Daniela Terracciano Giuseppe Di Lorenzo Riccardo Autorino Giuseppe Lucarelli Paola Del Prete Marco Borghesi Sisto Perdonà Martha Orsolya Katalin Francesco Cantiello Nicolae Crisan Ottavio De Cobelli Walter Artibani Rocco Damiano Giorgio Guazzoni Mihai Dorin Vartolomei

subject

Male medicine.medical_specialty Diabetes mellitu Urology medicine.medical_treatment 030232 urology & nephrology Urology Cystectomy Resection 03 medical and health sciences 0302 clinical medicine Diabetes mellitus High grade Adjuvants Immunologic Urethra Recurrence Diabetes mellitus medicine Humans In patient Neoplasm Invasiveness Aged Neoplasm Staging Retrospective Studies Bladder cancer Progression business.industry High risk Bladder cancer Type 2 Diabetes Mellitus Middle Aged medicine.disease Prognosis Comorbidity Progression-Free Survival 3. Good health Bladder cancer; Diabetes mellitus; High grade; High risk; Progression; Recurrence Settore MED/24 Oncology Diabetes Mellitus Type 2 Urinary Bladder Neoplasms Chemotherapy Adjuvant 030220 oncology & carcinogenesis Cohort BCG Vaccine Female Neoplasm Grading business Adjuvant

description

Objectives: The aim of this multicenter study was to investigate the prognostic role of type 2 diabetes mellitus (T2DM) comorbidity in a large multi-institutional cohort of patients with primary T1HG/G3 non–muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of the bladder (TURB). Materials and methods: A total of 1,172 patients with primary T1 HG/G3 who had NMIBC on re-TURB and who received adjuvant intravesical bacillus Calmette-Guérin therapy with maintenance were included. Endpoints were recurrence-free survival and progression-free survival. Results: A total of 231 (19.7%) of patients had T2DM prior to TURB. Five-year recurrence-free survival estimates were 12.5% in patients with T2DM compared to 36% in patients without T2DM, P < 0.0001. Five-year PFS estimates were 60.5% in patients with T2DM compared to 70.2% in patients without T2DM, P = 0.003. T2DM was independently associated with disease recurrence (hazard ratio = 1.41; 95% confidence interval = 1.20–1.66, P < 0.001) and progression (hazard ratio = 1.27; 95% confidence interval = 0.99–1.63, P < 0.001), after adjusting for other known predictive factors such as tumor size, multifocality, T1G3 on re-TURB, body mass index, lymphovascular invasion, and neutrophil-to-lymphocytes ratio. Conclusions: Given the potential implications for management, prospective validation of this finding along with translational studies designed to investigate the underlying biology of such an association are warranted.

year	journal	country	edition	language
2020-01-01	Urologic oncology

10.1016/j.urolonc.2020.02.016 https://pubmed.ncbi.nlm.nih.gov/32173242