The impact of metabolic syndrome on survival outcomes in urothelial carcinoma: a retrospective cohort study.

BACKGROUND/

OBJECTIVES

Urothelial carcinoma (UC) is a prevalent malignancy of the urinary system, associated with substantial morbidity and mortality. Metabolic syndrome (MetS), comprising obesity, hypertension, dyslipidemia, and hyperglycemia, has been implicated in cancer development, but its prognostic impact in UC remains unclear. This study aimed to explore the association between MetS and survival outcomes in UC patients.

METHODS

A single-center retrospective study was conducted, analyzing 112 patients with UC, diagnosed between January 2018 and February 2024. Patients were categorized based on the presence of MetS (≥ 3 criteria) or its individual components. Overall survival (OS) and progression-free survival (PFS) were evaluated using Kaplan-Meier estimates and Cox proportional hazard regression models, adjusting for disease stage and relevant covariates.

RESULTS

The cohort was predominantly male (82.1%), with a median age of 71.9 years (IQR 65.8-79). MetS was present in 49 patients (43.8%). After adjustment for stage, MetS was associated with poorer OS (HR 2.04, p=0.018) and PFS (HR 2.13, p=0.024). In multivariate analysis, MetS independently predicted OS (HR 2.27, p=0.038). Diabetes was the strongest individual predictor of adverse outcomes (adjusted HR for OS 3.33, p=0.001; PFS 3.35, p=0.002). Hypertension also independently predicted worse OS (HR 1.96, p=0.039), whereas obesity and dyslipidemia were not associated with survival.

CONCLUSIONS

MetS and its components, particularly diabetes and hypertension, were associated with poorer survival outcomes in patients with UC. Further prospective studies are required to determine whether optimization of metabolic health can improve oncological outcomes.