Analysis of diabetes mellitus increasing the risk of intravesical recurrence in patients with upper urinary tract urothelial carcinoma after radical nephroureterectomy
10.3969/j.issn.1000-8179.2016.15.522
- VernacularTitle:糖尿病对上尿路尿路上皮癌根治术后发生膀胱内肿瘤的风险分析
- Author:
Yuting GUO
;
Changping LI
;
Zhuang CUI
;
Yuanyuan LIU
;
Jun MA
- Publication Type:Journal Article
- Keywords:
diabetes mellitus;
urothelial carcinoma;
radical nephroureterectomy;
bladder neoplasm;
recurrence
- From:
Chinese Journal of Clinical Oncology
2016;43(15):663-667
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate whether the risk of intravesical recurrence increases in patients with upper urinary tract urothelial carcinoma (UUT-UC) and diabetes mellitus (DM) after radical nephroureterectomy (RNU) with bladder cuff excision. Methods:We ret-rospectively analyzed the clinicopathological data of 282 UUT-UC patients with no history of bladder neoplasm and who underwent RNU with bladder cuff excision in the Second Hospital of Tianjin Medical University from January 2005 to December 2013. The recurrence-free survival (RFS) and cancer-specific survival (CSS) were compared between the non-diabetic (233 patients) and diabetic (49 patients) patients. The factors influencing intravesical recurrence in patients with UUT-UC after RNU were analyzed. These factors included age, DM, pathologic grade, and stage. Results:Among the 282 patients included in the study, 80 (28.4%) patients developed intravesical recurrence during the median fol ow up of 41 months, and the median time to recurrence was 11 months. Non-diabetic patients had a significantly longer duration of bladder neoplasm RFS than diabetic patients (P=0.013). Multivariate analysis using Cox's regression model indicated that DM (P=0.014), renal pelvis and ureter tumor (P=0.001), and postoperative chemotherapy (P=0.024) were independent influential factors for intravesical recurrence in patients with UUT-UC after RNU with bladder cuff excision. Conclusion:DM posed an increased risk for intravesical recurrence after RNU with bladder cuff excision in patients with UUT-UC. Therefore, these patients need to be closely monitored, and their blood glucose must be controlled.
