Matteo Ferro1, Martha Orsolya Katalin2, Carlo Buonerba3, Raluca Marian4, Francesco Cantiello5, Gennaro Musi6, Savino Di Stasi7, Rodolfo Hurle8, Giorgio Guazzoni8, Gian Maria Busetto9, Francesco Del Giudice9, Sisto Perdonà10, Paola Del Prete11, Vincenzo Mirone12, Marco Borghesi13, Angelo Porreca14, Walter Artibani14, Pierluigi Bove15, Estevao Lima16, Riccardo Autorino17, Nicolae Crisan18, Abdal Rahman Abu Farhan5, Michele Battaglia19, Pasquale Ditonno19, Vincenzo Serretta20, Giorgio Ivan Russo21, Daniela Terracciano22, Giuseppe di Lorenzo23, Rocco Damiano5, Guru Sonpavde24, Mihai Dorin Vartolomei25, Ottavio de Cobelli26, Giuseppe Lucarelli19. 1. Division of Urology, European Institute of Oncology-IRCCS, Milan, Italy. Electronic address: matteo.ferro@ieo.it. 2. Department of Urology, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania. 3. CRTR Rare Tumors Reference Center, AOU Federico II, Napoli, Italy; Environment & Health Operational Unit, Zoo-prophylactic Institute of Southern Italy, Portici, Italy. 4. Department of Cell and Molecular Biology, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania. 5. Department of Urology, Magna Graecia University of Catanzaro, Catanzaro, Italy. 6. Division of Urology, European Institute of Oncology-IRCCS, Milan, Italy. 7. Department of Experimental Medicine and Surgery, Tor Vegata University, Rome, Italy. 8. Department of Urology, Humanitas Clinical and Research Hospital, Rozzano (Milan), Italy. 9. Department of Urology, La Sapienza University of Rome, Rome, Italy. 10. Uro-Gynecological Department, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "G. Pascale"-IRCCS, Naples, Italy. 11. Scientific Directorate, Istituto Nazionale per lo Studio e la Cura dei Tumori, Fondazione "G. Pascale"-IRCCS, Naples, Italy. 12. Department of Neurosciences, Sciences of Reproduction and Odontostomatology, Urology Unit, University Federico II, Napoli, Italy. 13. Department of Urology, University of Bologna, Bologna, Italy. 14. Department of Robotic Urologic Surgery, Abano Terme Hospital, Abano Terme, Italy. 15. Division of Urology, Department of Experimental Medicine and Surgery, Urology Unit, Tor Vergata University of Rome, Rome, Italy. 16. Life and Health Sciences Research Institute, University of Minho, Braga, Portugal. 17. Division of Urology, Virginia Commonwealth University, Richmond, VA. 18. Department of Urology, University of Medicine and Pharmacy Iuliu Haţieganu, Cluj-Napoca, Romania. 19. Department of Emergency and Organ Transplantation, Urology, Andrology and Kidney Transplantation Unit, University of Bari, Bari, Italy. 20. Department of Surgical, Oncological and Stomatological Sciences, University of Palermo, Palermo, Italy. 21. Department of Urology, University of Catania, Catania, Italy. 22. Department of Translational Medical Sciences, University Federico II, Napoli, Italy. 23. Department of Clinical Medicine and Surgery, University Federico II, Napoli, Italy; Department of Medicine, University of Molise, Campobasso, Italy. 24. Genitourinary Oncology Section, Dana Farber Cancer Institute, Boston, MA. 25. Division of Urology, European Institute of Oncology-IRCCS, Milan, Italy; Department of Cell and Molecular Biology, University of Medicine, Pharmacy, Sciences and Technology, Tirgu Mures, Romania. 26. Division of Urology, European Institute of Oncology-IRCCS, Milan, Italy; Università degli Studi di Milano, Milan, Italy.
Abstract
OBJECTIVES: The aim of this multicenter study was to investigate the prognostic role of type 2 diabetes mellitus (T2DM) comorbidity in a large multi-institutional cohort of patients with primary T1HG/G3 non-muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of the bladder (TURB). 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.
OBJECTIVES: The aim of this multicenter study was to investigate the prognostic role of type 2 diabetes mellitus (T2DM) comorbidity in a large multi-institutional cohort of patients with primary T1HG/G3 non-muscle-invasive bladder cancer (NMIBC) treated with transurethral resection of the bladder (TURB). 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.
Authors: Vittorio Fasulo; Marco Paciotti; Massimo Lazzeri; Roberto Contieri; Paolo Casale; Alberto Saita; Giovanni Lughezzani; Pietro Diana; Nicola Frego; Pier Paolo Avolio; Piergiuseppe Colombo; Grazia Maria Elefante; Giorgio Guazzoni; Nicolò Maria Buffi; Michael Bates; Rodolfo Hurle Journal: Front Oncol Date: 2022-01-27 Impact factor: 6.244