https://scholars.lib.ntu.edu.tw/handle/123456789/542087
標題: | Diabetes mellitus with poor glycemic control increases bladder cancer recurrence risk in patients with upper urinary tract urothelial carcinoma | 作者: | Tai Y.-S. CHUNG-HSIN CHEN CHAO-YUAN HUANG Tai H.-C. Wang S.-M. YEONG-SHIAU PU |
公開日期: | 2015 | 出版社: | John Wiley and Sons Ltd | 卷: | 31 | 期: | 3 | 起(迄)頁: | 307-314 | 來源出版物: | Diabetes/Metabolism Research and Reviews | 摘要: | Background: The association of diabetes mellitus and bladder cancer recurrence following radical nephroureterectomies (RNUs) in patients with upper urinary tract urothelial carcinoma (UTUC) was investigated. Methods: Between January 1996 and March 2009, 538 patients with UTUC who received RNU and had no previous bladder cancer histories were enrolled. The clinicopathological characteristics were obtained and used for the analysis of metachronous bladder recurrence by using Cox proportional hazard model. Results: The diabetic patients (N=104, 19.3%) were elderly (72 vs 67 years, p<0.001) and had more hypertension (56.7 vs 34.5%, p<0.001) as compared with non-diabetic patients. There was no significant difference in the rest of clinicopathological characteristics between patient groups. During the median follow-up duration of 51 months, bladder recurrences were discovered in 47.1 and 33.1% of diabetic and non-diabetic patients with UTUC, respectively. Poorly controlled diabetic patients (HbA1c?7.0%) exhibited a shorter duration of bladder cancer recurrence-free survival as compared with those with good glycemic controlled diabetes mellitus and without diabetes mellitus (log-rank test, p<0.001 and <0.001, respectively). In the multivariate analysis, male gender [hazard ratio (HR)=1.67, p=0.017], ureteral tumour (HR=1.61, p=0.020), end-stage renal disease (HR=2.09, p=0.030) and diabetes mellitus with poor glycemic control (HR=2.10, p<0.018) independently predicted bladder recurrence after RNU. Conclusions: Diabetes mellitus with poor glycemic control (HbA1c?7.0%) increases the risk of subsequent bladder cancer recurrence. These results underscore the need for intensive glycemic control and close follow-up for diabetic patients. ? 2014 John Wiley & Sons, Ltd. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-84924285088&doi=10.1002%2fdmrr.2614&partnerID=40&md5=1ac339661222c3faea12a88da5112e5b https://scholars.lib.ntu.edu.tw/handle/123456789/542087 |
ISSN: | 1520-7552 | DOI: | 10.1002/dmrr.2614 | SDG/關鍵字: | adult; aged; Article; bladder cancer; cancer recurrence; controlled study; diabetes mellitus; diabetic patient; end stage renal disease; female; follow up; glycemic control; human; hypertension; major clinical study; male; nephroureterectomy; priority journal; recurrence free survival; recurrence risk; transitional cell carcinoma; upper urinary tract urothelial carcinoma; ureter tumor; urinary tract; adverse effects; cancer staging; case control study; cohort analysis; complication; diabetes mellitus; hyperglycemia; hypoglycemia; middle aged; mortality; nephrectomy; pathology; pathophysiology; postoperative complication; prognosis; survival rate; tumor invasion; tumor recurrence; Urinary Bladder Neoplasms; Urologic Neoplasms; Aged; Case-Control Studies; Cohort Studies; Diabetes Mellitus; Female; Follow-Up Studies; Humans; Hyperglycemia; Hypoglycemia; Male; Middle Aged; Neoplasm Invasiveness; Neoplasm Recurrence, Local; Neoplasm Staging; Nephrectomy; Postoperative Complications; Prognosis; Survival Rate; Urinary Bladder Neoplasms; Urologic Neoplasms |
顯示於: | 醫學系 |
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