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