Hwang, Eu Chang; Kim, Young Jung; Hwang, In Sang; Hwang, Jun Eul; Jung, Seung Il; Kwon, Dong Deuk; Park, Kwangsung; Ryu, Soo Bang
International journal of urology : official journal of the Japanese Urological Association
2011Nov ; 18 ( 11 ) :769-76.
PMID : 21914000
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Hwang, Eu Chang -
Kim, Young Jung -
Hwang, In Sang -
Hwang, Jun Eul -
Jung, Seung Il -
Kwon, Dong Deuk -
Park, Kwangsung -
Ryu, Soo Bang -
ABSTRACT
OBJECTIVE: The aim of the present study was to investigate the relationship between diabetes mellitus (DM) and tumor features in patients with non-muscle invasive bladder cancer (NMIBC).
METHODS: Data from 251 patients who underwent transurethral resection (TUR) for NMIBC from January 2000 to June 2010 were analyzed retrospectively. Patients were divided into two groups: Group I, 159 patients (63%) who did not have DM at the time of surgery; and (ii) Group II, 92 patients (37%) who had DM at the time of surgery. Recurrence- and progression-free survival was assessed in both groups. Preoperative HbA1c levels, as parameter of glycemic control, were determined in Group II patients, with patients divided into two subgroups: (i) HbA1c ??7.0%; and (ii) HbA1c <7.0%. The clinical features of the bladder tumor were compared in these two subgroups.
RESULTS: Compared with Group I, Group II patients were older and had a higher rate of hypertension, recurrence, and progression (P < 0.05). Univariate survival analysis showed that gender, DM, smoking, and serum creatinine were associated with recurrence-free survival (P < 0.05), whereas DM, stage, grade, intravesical instillation, and serum creatinine were associated with progression-free survival. In multivariate survival analysis, DM was found to be an independent factor for recurrence- (hazard ratio [HR] 2.11; 95% confidence interval [CI] 1.4-3.2; P = 0.001) and progression-free survival (HR 9.35; 95% CI 3.1-28.6; P = 0.001). Furthermore, patients with HbA1c ??7.0% exhibited a significantly higher rate of multiplicity (P = 0.001), tumor grade (P = 0.03), and intravesical treatment (P = 0.04).
CONCLUSIONS: In conclusion, DM seems to be an independent predictor of recurrence- and progression-free survival in NMIBC patients. Further prospective studies are needed to establish the prognostic significance of postoperative glycemic control in this patient population. CI - ??2011 The Japanese Urological Association.
diabetes mellitus, progression, recurrence, urinary bladder neoplasm
MESH
Aged, Carcinoma in Situ/complications/*pathology/surgery, Creatinine/blood, Diabetes Complications/*complications, *Diabetes Mellitus/blood, *Disease Progression, Disease-Free Survival, Female, Hemoglobin A, Glycosylated/metabolism, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local/*complications, Proportional Hazards Models, Retrospective Studies, Sex Factors, Smoking, Urinary Bladder Neoplasms/complications/*pathology/surgery
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