TY - JOUR
T1 - 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
AU - Ferro, Matteo
AU - Katalin, Martha Orsolya
AU - Buonerba, Carlo
AU - Marian, Raluca
AU - Cantiello, Francesco
AU - Musi, Gennaro
AU - Di Stasi, Savino
AU - Hurle, Rodolfo
AU - Guazzoni, Giorgio
AU - Busetto, Gian Maria
AU - Del Giudice, Francesco
AU - Perdonà, Sisto
AU - Del Prete, Paola
AU - Mirone, Vincenzo
AU - Borghesi, Marco
AU - Porreca, Angelo
AU - Artibani, Walter
AU - Bove, Pierluigi
AU - Lima, Estevao
AU - Autorino, Riccardo
AU - Crisan, Nicolae
AU - Abu Farhan, Abdal Rahman
AU - Battaglia, Michele
AU - Ditonno, Pasquale
AU - Serretta, Vincenzo
AU - Russo, Giorgio Ivan
AU - Terracciano, Daniela
AU - di Lorenzo, Giuseppe
AU - Damiano, Rocco
AU - Sonpavde, Guru
AU - Vartolomei, Mihai Dorin
AU - de Cobelli, Ottavio
AU - Lucarelli, Giuseppe
N1 - Copyright © 2020 Elsevier Inc. All rights reserved.
PY - 2020/5
Y1 - 2020/5
N2 - 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.
AB - 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.
U2 - 10.1016/j.urolonc.2020.02.016
DO - 10.1016/j.urolonc.2020.02.016
M3 - Article
C2 - 32173242
VL - 38
SP - 459
EP - 464
JO - Urol. Oncol. Semin. Orig. Invest.
JF - Urol. Oncol. Semin. Orig. Invest.
SN - 1078-1439
IS - 5
ER -