Impact of Glycemic Control and Metformin Use on the Recurrence and Progression of Non-Muscle Invasive Bladder Cancer in Patients with Diabetes Mellitus.
10.3346/jkms.2016.31.9.1464
- Author:
Ji Hoon AHN
1
;
Seung Il JUNG
;
Sang Un YIM
;
Sun Woo KIM
;
Eu Chang HWANG
;
Dong Deuk KWON
Author Information
1. Department of Urology, Chonnam National University Medical School, Gwangju, Korea. drjsi@yahoo.co.kr
- Publication Type:Original Article
- Keywords:
Diabetes Mellitus;
Progression;
Recurrence;
Bladder Cancer;
Metformin
- MeSH:
Diabetes Mellitus*;
Disease-Free Survival;
Follow-Up Studies;
Humans;
Kaplan-Meier Estimate;
Metformin*;
Recurrence*;
Urinary Bladder Neoplasms*;
Urinary Bladder*
- From:Journal of Korean Medical Science
2016;31(9):1464-1471
- CountryRepublic of Korea
- Language:English
-
Abstract:
The purpose of the present study was to determine the potential relationships of glycemic control and use of metformin with non-muscle invasive bladder cancer characteristics. We reviewed data from 645 patients with non-muscle invasive bladder cancer between January 2004 and May 2015. We analyzed the association of pre and post-operative glycemic control and use of metformin with clinical characteristics of bladder tumors. We also analyzed the association of glycemic control and use of metformin with recurrence-free and progression-free survivals. Diabetes mellitus patients showed decreased recurrence-free survival (hazard ratio 1.42; 95% confidence interval 1.1-1.9; P = 0.021) and progression-free survival (hazard ratio 1.79; 95% confidence interval 1.1-2.8; P = 0.013). Diabetes mellitus patients with a HbA1c ≥ 7.0% demonstrated a higher rate of progression (P = 0.026). Kaplan-Meier analysis showed that progression-free survival rate was associated with poor baseline glycemic control (P = 0.026) and post-operative glycemic control (P = 0.025). However, use of metformin had no impact on the recurrence (P = 1.00) and progression (P = 0.282). In conclusion, poor baseline and post-operative glycemic control was related with shorter progression-free survival of patients with non-muscle invasive bladder cancer. Use of metformin had no impact on the recurrence and progression. Therefore, tight glycemic control and close follow-up for bladder tumor may be beneficial in patients with poor glycemic control.
