Association of diabetes mellitus and metformin use with oncological outcomes of patients with non-muscle-invasive bladder cancer
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Association of diabetes mellitus and metformin use with oncological outcomes of patients with non-muscle-invasive bladder cancer. / Rieken, Malte; Xylinas, Evanguelos; Kluth, Luis; Crivelli, Joseph J; Chrystal, James; Faison, Talia; Lotan, Yair; Karakiewicz, Pierre I; Fajkovic, Harun; Babjuk, Marek; Kautzky-Willer, Alexandra; Bachmann, Alexander; Scherr, Douglas S; Shariat, Shahrokh F.
in: BJU INT, Jahrgang 112, Nr. 8, 01.12.2013, S. 1105-12.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Association of diabetes mellitus and metformin use with oncological outcomes of patients with non-muscle-invasive bladder cancer
AU - Rieken, Malte
AU - Xylinas, Evanguelos
AU - Kluth, Luis
AU - Crivelli, Joseph J
AU - Chrystal, James
AU - Faison, Talia
AU - Lotan, Yair
AU - Karakiewicz, Pierre I
AU - Fajkovic, Harun
AU - Babjuk, Marek
AU - Kautzky-Willer, Alexandra
AU - Bachmann, Alexander
AU - Scherr, Douglas S
AU - Shariat, Shahrokh F
N1 - © 2013 The Authors. BJU International © 2013 BJU International.
PY - 2013/12/1
Y1 - 2013/12/1
N2 - OBJECTIVE: To assess the association between diabetes mellitus (DM) and metformin use with prognosis and outcomes of non-muscle-invasive bladder cancer (NMIBC) PATIENTS AND METHODS: We retrospectively evaluated 1117 patients with NMIBC treated at four institutions between 1996 and 2007. Cox regression models were used to analyse the association of DM and metformin use with disease recurrence, disease progression, cancer-specific mortality and any-cause mortality.RESULTS: Of the 1117 patients, 125 (11.1%) had DM and 43 (3.8%) used metformin. Within a median (interquartile range) follow-up of 64 (22-106) months, 469 (42.0%) patients experienced disease recurrence, 103 (9.2%) experienced disease progression, 50 (4.5%) died from bladder cancer and 249 (22.3%) died from other causes. In multivariable Cox regression analyses, patients with DM who did not take metformin had a greater risk of disease recurrence (hazard ratio [HR]: 1.45, 95% confidence interval [CI] 1.09-1.94, P = 0.01) and progression (HR: 2.38, 95% CI 1.40-4.06, P = 0.001) but not any-cause mortality than patients without DM. DM with metformin use was independently associated with a lower risk of disease recurrence (HR: 0.50, 95% CI 0.27-0.94, P = 0.03).CONCLUSION: Patients with DM and NMIBC who do not take metformin seem to be at an increased risk of disease recurrence and progression; metformin use seems to exert a protective effect with regard to disease recurrence. The mechanisms behind the impact of DM on patients with NMIBC and the potential protective effect of metformin need further elucidation.
AB - OBJECTIVE: To assess the association between diabetes mellitus (DM) and metformin use with prognosis and outcomes of non-muscle-invasive bladder cancer (NMIBC) PATIENTS AND METHODS: We retrospectively evaluated 1117 patients with NMIBC treated at four institutions between 1996 and 2007. Cox regression models were used to analyse the association of DM and metformin use with disease recurrence, disease progression, cancer-specific mortality and any-cause mortality.RESULTS: Of the 1117 patients, 125 (11.1%) had DM and 43 (3.8%) used metformin. Within a median (interquartile range) follow-up of 64 (22-106) months, 469 (42.0%) patients experienced disease recurrence, 103 (9.2%) experienced disease progression, 50 (4.5%) died from bladder cancer and 249 (22.3%) died from other causes. In multivariable Cox regression analyses, patients with DM who did not take metformin had a greater risk of disease recurrence (hazard ratio [HR]: 1.45, 95% confidence interval [CI] 1.09-1.94, P = 0.01) and progression (HR: 2.38, 95% CI 1.40-4.06, P = 0.001) but not any-cause mortality than patients without DM. DM with metformin use was independently associated with a lower risk of disease recurrence (HR: 0.50, 95% CI 0.27-0.94, P = 0.03).CONCLUSION: Patients with DM and NMIBC who do not take metformin seem to be at an increased risk of disease recurrence and progression; metformin use seems to exert a protective effect with regard to disease recurrence. The mechanisms behind the impact of DM on patients with NMIBC and the potential protective effect of metformin need further elucidation.
KW - Aged
KW - Aged, 80 and over
KW - Diabetes Mellitus
KW - Disease Progression
KW - Disease-Free Survival
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Hypoglycemic Agents
KW - Male
KW - Metformin
KW - Middle Aged
KW - Neoplasm Invasiveness
KW - Neoplasm Recurrence, Local
KW - Predictive Value of Tests
KW - Prognosis
KW - Proportional Hazards Models
KW - Retrospective Studies
KW - Treatment Outcome
KW - Urinary Bladder Neoplasms
U2 - 10.1111/bju.12448
DO - 10.1111/bju.12448
M3 - SCORING: Journal article
C2 - 24053906
VL - 112
SP - 1105
EP - 1112
JO - BJU INT
JF - BJU INT
SN - 1464-4096
IS - 8
ER -