Department of Urology, National Taiwan University Hospital, National Taiwan University, College of Medicine, No.7, Chung-Shan South Road, Zhongzheng District, Taipei, 100, Taiwan.
BMC Urol. 2020 Aug 5;20(1):117. doi: 10.1186/s12894-020-00684-5.
Hyperglycemia is associated with series of process leading to oncogenesis. Evidence has shown that diabetes mellitus (DM) seems to be associated with poor prognosis in patients with bladder cancer. However, evidence on the effect of glycemic control on the outcomes of bladder cancer is still limited. In the current study, we aimed to investigate the effect of DM and glycemic control on the prognosis of bladder cancer.
We conducted a retrospective chart review of a prospective database from January 2012 to December 2017. Patients with newly diagnosed non-muscle invasive bladder cancer (NMIBC) were included. They were classified into the DM and non-DM groups. Prognosis including recurrence rate, progression rate, recurrence-free survival (RFS), and progression-free survival was compared between the two groups. Subgroup analysis of the DM subgroup, in which patients were classified by HbA1C level, was conducted to investigate the effect of glycemic control.
A total of 287 patients were included in our study, with 61 patients in the DM group and 226 patients in the non-DM group. No statistically significant difference was found in the prognosis between the DM and non-DM groups. Subgroup analysis revealed higher recurrence rate (P = 0.037) and worse RFS (log-rank P = 0.019) in patients with HbA1C ≥ 7.
DM is not a risk factor for recurrence and progression in patients with NMIBC. However, poor glycemic control is associated with poor prognosis in patients with both DM and NMIBC. Further prospective studies are needed to confirm current results.
高血糖与一系列导致癌变的过程有关。有证据表明，糖尿病（DM）似乎与膀胱癌患者的预后不良有关。然而，关于血糖控制对膀胱癌结局影响的证据仍然有限。在本研究中，我们旨在探讨 DM 和血糖控制对膀胱癌预后的影响。
我们对 2012 年 1 月至 2017 年 12 月期间前瞻性数据库进行了回顾性图表审查。纳入新诊断的非肌肉浸润性膀胱癌（NMIBC）患者。他们被分为 DM 和非 DM 组。比较两组的预后，包括复发率、进展率、无复发生存率（RFS）和无进展生存率。对 DM 亚组进行亚组分析，根据 HbA1C 水平对患者进行分类，以探讨血糖控制的影响。
共有 287 例患者纳入本研究，DM 组 61 例，非 DM 组 226 例。DM 组和非 DM 组的预后无统计学差异。亚组分析显示，HbA1C≥7 的患者复发率较高（P=0.037），RFS 较差（对数秩 P=0.019）。
DM 不是 NMIBC 患者复发和进展的危险因素。然而，血糖控制不佳与 DM 和 NMIBC 患者的预后不良有关。需要进一步的前瞻性研究来证实目前的结果。
