Impact of Glycemic Control and Metformin Use on the Recurrence and Progression of Non-Muscle Invasive Bladder Cancer in Patients with Diabetes Mellitus
Journal of Korean Medical Science 2016³â 31±Ç 9È£ p.1464 ~ p.1471
¾ÈÁöÈÆ(Ahn Ji-Hoon) - Chonnam National University Medical School Department of Urology
Á¤½ÂÀÏ(Jung Seung-Il) - Chonnam National University Medical School Department of Urology
(Yim Sang-Un) - Chonnam National University Medical School Department of Urology
±è¼±¿ì(Kim Sun-Woo) - Chonnam National University Medical School Department of Urology
ȲÀÇâ(Hwang Eu-Chang) - Chonnam National University Medical School Department of Urology
±Çµ¿µæ(Kwon Dong-Deuk) - Chonnam National University Medical School Department of Urology
Abstract
The purpose of the present study was to determine the potential relationships of glycemic control and use of metformin with non-muscle invasive bladder cancer characteristics. We reviewed data from 645 patients with non-muscle invasive bladder cancer between January 2004 and May 2015. We analyzed the association of pre and post-operative glycemic control and use of metformin with clinical characteristics of bladder tumors. We also analyzed the association of glycemic control and use of metformin with recurrence-free and progression-free survivals. Diabetes mellitus patients showed decreased recurrence-free survival (hazard ratio 1.42; 95% confidence interval 1.1?1.9; P = 0.021) and progression-free survival (hazard ratio 1.79; 95% confidence interval 1.1?2.8; P = 0.013). Diabetes mellitus patients with a HbA1c ¡Ã 7.0% demonstrated a higher rate of progression (P = 0.026). Kaplan-Meier analysis showed that progression-free survival rate was associated with poor baseline glycemic control (P = 0.026) and post-operative glycemic control (P = 0.025). However, use of metformin had no impact on the recurrence (P = 1.00) and progression (P = 0.282). In conclusion, poor baseline and post-operative glycemic control was related with shorter progression-free survival of patients with non-muscle invasive bladder cancer. Use of metformin had no impact on the recurrence and progression. Therefore, tight glycemic control and close follow-up for bladder tumor may be beneficial in patients with poor glycemic control.
Å°¿öµå
Diabetes Mellitus, Progression, Recurrence, Bladder Cancer, Metformin
KMID :
0191120160310091464
¿ø¹® ¹× ¸µÅ©¾Æ¿ô Á¤º¸
µîÀçÀú³Î Á¤º¸
À¯È¿¼º°á°ú(Recomendation)
After analyzing the association of glycemic control and use of metformin with recurrence-free and progression-free survivals. Diabetes mellitus patients showed decreased recurrence-free survival (hazard ratio 1.42; 95% confidence interval 1.1?.9; P = 0.021) and progression-free survival (hazard ratio 1.79; 95% confidence interval 1.1?.8; P = 0.013).