Association between diabetes mellitus and oncological outcomes in bladder cancer patients undergoing radical cystectomy

Oh, Jong Jin; Kang, Min Yong; Jo, Jung Ki; Lee, Hak Min; Byun, Seok‐Soo; Lee, Sang Eun; Hong, Sung Kyu

doi:10.1111/iju.12901

Cited by 14 publications

(10 citation statements)

References 21 publications

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“…Masaoka and his teammates (30) declared that smoking was a persuasive risk factor for BC in Japanese. Other factors such as obesity (31)(32)(33), and diabetes (34)(35)(36) were also considered to be related to the occurrence and development of BC. Coincidentally, these factors are highly recognized to be tightly associated with the risk of CVD, which could well explain the higher proportion of CVD mortality in UBC patients.…”

Section: Discussionmentioning

confidence: 99%

An overview of patients with urothelial bladder cancer over the past two decades: a Surveillance, Epidemiology, and End Results (SEER) study

Zang¹,

Xiao²,

Cheng³

et al. 2020

Ann Transl Med

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Background: To explore the overall trends of incidence rate (IR), mortality and survival outcomes of patients with urothelial bladder cancer (UBC) over the past two decades.Methods: Patients diagnosed with UBC from 1993 to 2012 were extracted from the Surveillance, Epidemiology and End Result (SEER) 18 database. Baseline characteristics and treatment types of included patients were collected retrospectively. Moreover, the age-adjusted IRs and annual percent changes (APCs) were obtained. Afterwards, we calculated the standardized mortality ratios (SMRs) for bladder cancer (BC), cardiovascular disease (CVD) and all-cause mortality by comparing UBC cases with the general population. Finally, survival outcomes of UBC patients were analyzed and compared. Results: A total of 220,405 UBC patients were identified, including 167,036 (75.79%) male patients and 53,369 (24.21%) female patients, with an average age of 70.84 years old. Most patients were White (89.85%), with older age (71.67%, >65 years old), lower T stage diseases (78.11%, < T2) and lower median household income (55.37%). When compared with patients diagnosed between 1993 and 2002, those diagnosed between 2003 and 2012 had older age (mean: 71.15 vs. 70.16 years old, P<0.001), higher proportion of men (76.22% vs. 74.83%, P<0.001) and lower median household income (56.69% vs. 52.50%, P<0.01). Overall, the IR of UBC increased slightly before 2003 and maintained a stable trend of about 20 per 100,000 personyears after 2003. Additionally, CVD was recognized as an important cause of death (COD) of UBC patients.UBC patients were 44.5 times more likely to die of CVD when compared with the general population.Furthermore, the 3-, 5-and 10-year overall survival (OS) and cancer-specific survival (CSS) rates were 0.709, 0.609 and 0.421, and 0.861, 0.831 and 0.789, respectively. Finally, survival outcomes between patients diagnosed in the two periods (1993-2002 vs. 2003-2012) were not significantly different. Conclusions:The IR of UBC increased slightly before 2003 and remained stable after 2003. UBC patients had higher CVD burden than the general population. Hence, cardiovascular health should be emphasized to reduce mortality after UBC diagnosis. Lastly, survival outcomes of UBC patients in the last two decades showed no significant difference.

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Section: Discussionmentioning

confidence: 99%

An overview of patients with urothelial bladder cancer over the past two decades: a Surveillance, Epidemiology, and End Results (SEER) study

Zang¹,

Xiao²,

Cheng³

et al. 2020

Ann Transl Med

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“…And we performed the full-text screening, we nally 5 studies in the present analysis. [8][9][10][11][12] The screening procedure was showed in the Fig. 1.…”

Section: Resultsmentioning

confidence: 99%

The Prognostic Value of Diabetes in Patients Underwent Radical Cystectomy: A Meta- analysis

Xiang

Tao

et al. 2022

Preprint

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Objective To systematically evaluate the impact of diabetes on the prognosis of bladder cancer patients after radical cystectomy (RC). Methods PubMed, Embase, Cochrane Library database were selected from the inception to the October 2021. The studies on the effects of diabetes on bladder cancer patients after RC were included for analysis. The inclusion and exclusion criteria were independently selected for literature screening, the quality of the included studies was evaluated and data were extracted. Results A total of 5 cohort studies were included, with a total of 2 661 subjects, including 391 cases in the diabetic group, non-diabetes. Meta-analysis results show that diabetes increases the overall risk of death in patients after RC (HR = 1.36, 95%CI: 1.30 ~ 1.43, P < 0.001) and the risk of tumor-specific death (HR = 1.59, 95%CI: 1.29 ~ 1.95, P < 0.001). Sensitivity analysis shows that the stability of this study is well. Conclusion Diabetes was an independent risk factor in terms of overall and cancer-specific survival in patients underwent RC.

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“…Unfortunately, our results found that those factors are underpowered to reveal any association with complications. Evidence that the risk of post-RARC complications is significantly higher in patients with DM, CKD, and dyslipidemia has been reviewed separately and individually in several literatures, [14][15][16][17][18][19][20] but our strength is considered to be the first to try to reveal an association in one study at once. Knorr et al 16 reported that chronic obstructive pulmonary disease (P = 0.030), CCI (P = 0.020), and Indiana pouch diversion (P = 0.002) were significant predictors of early complication.…”

Section: Discussionmentioning

confidence: 99%

Predicting factor analysis of postoperative complications after robot‐assisted radical cystectomy: Multicenter KORARC database study

et al. 2022

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Objectives To evaluate postoperative complications following robot‐assisted radical cystectomy in patients diagnosed with bladder cancer and reveal if there are predictors for postoperative complications. Methods Prospectively collected medical records of 730 robot‐assisted radical cystectomy patients between 2007/04 and 2019/05 in 13 tertiary referral centers were reviewed. Perioperative outcomes were compared between two groups by postoperative complications (complication vs non‐complication). We assessed recurrence‐free survival, cancer‐specific survival, and overall survival between groups. Regression analyses were implemented to identify factors associated with postoperative complications. Results Any total and high‐grade complication (Clavien–Dindo grade ≥3) rates were 57.8% and 21.1%, respectively. Patients in complication group had significantly higher proportion of diabetes mellitus (P = 0.048), chronic kidney disease (P = 0.011), dyslipidemia (P < 0.001), longer operation time (P = 0.001), more estimated blood loss (P = 0.001), and larger intraoperative fluid volume (P < 0.001). There was a significant difference in cancer‐specific survival (log‐rank P = 0.038, median cancer‐specific survival: both groups not reached). Dyslipidemia (odds ratio 2.59, P = 0.002) and intraoperative fluid volume (odds ratio 1.0002, P = 0.040) were significantly associated with high‐grade postoperative complications. Diabetes mellitus (odds ratio 1.97, P = 0.028), chronic kidney disease (odds ratio 1.89, P = 0.046), dyslipidemia (odds ratio 5.94, P = 0.007), and intraoperative fluid volume (odds ratio 1.0002, P = 0.009) were significantly associated with any postoperative complications. Conclusions Patients with diabetes mellitus, chronic kidney disease, dyslipidemia, or a relatively large intraoperatively infused fluid volume are more likely to develop postoperative complications. Patients with postoperative complications might have a possibility of lower cancer‐specific survival rate.

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Association between diabetes mellitus and oncological outcomes in bladder cancer patients undergoing radical cystectomy

Cited by 14 publications

References 21 publications

An overview of patients with urothelial bladder cancer over the past two decades: a Surveillance, Epidemiology, and End Results (SEER) study

An overview of patients with urothelial bladder cancer over the past two decades: a Surveillance, Epidemiology, and End Results (SEER) study

The Prognostic Value of Diabetes in Patients Underwent Radical Cystectomy: A Meta- analysis

Predicting factor analysis of postoperative complications after robot‐assisted radical cystectomy: Multicenter KORARC database study

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