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Diabetes mellitus without metformin intake is associated with worse oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma

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Diabetes mellitus without metformin intake is associated with worse oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma. / Rieken, M; Xylinas, E; Kluth, L; Trinh, Q-D; Lee, R K; Fajkovic, H; Novara, G; Margulis, V; Lotan, Y; Martinez-Salamanca, J I; Matsumoto, K; Seitz, C; Remzi, M; Karakiewicz, P I; Scherr, D S; Briganti, A; Kautzky-Willer, A; Bachmann, A; Shariat, S F; UTUC Collaboration.

in: EJSO-EUR J SURG ONC, Jahrgang 40, Nr. 1, 01.01.2014, S. 113-120.

Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung

Harvard

Rieken, M, Xylinas, E, Kluth, L, Trinh, Q-D, Lee, RK, Fajkovic, H, Novara, G, Margulis, V, Lotan, Y, Martinez-Salamanca, JI, Matsumoto, K, Seitz, C, Remzi, M, Karakiewicz, PI, Scherr, DS, Briganti, A, Kautzky-Willer, A, Bachmann, A, Shariat, SF & UTUC Collaboration 2014, 'Diabetes mellitus without metformin intake is associated with worse oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma', EJSO-EUR J SURG ONC, Jg. 40, Nr. 1, S. 113-120. https://doi.org/10.1016/j.ejso.2013.09.016

APA

Rieken, M., Xylinas, E., Kluth, L., Trinh, Q-D., Lee, R. K., Fajkovic, H., Novara, G., Margulis, V., Lotan, Y., Martinez-Salamanca, J. I., Matsumoto, K., Seitz, C., Remzi, M., Karakiewicz, P. I., Scherr, D. S., Briganti, A., Kautzky-Willer, A., Bachmann, A., Shariat, S. F., & UTUC Collaboration (2014). Diabetes mellitus without metformin intake is associated with worse oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma. EJSO-EUR J SURG ONC, 40(1), 113-120. https://doi.org/10.1016/j.ejso.2013.09.016

Vancouver

Rieken M, Xylinas E, Kluth L, Trinh Q-D, Lee RK, Fajkovic H et al. Diabetes mellitus without metformin intake is associated with worse oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma. EJSO-EUR J SURG ONC. 2014 Jan 1;40(1):113-120. https://doi.org/10.1016/j.ejso.2013.09.016

Bibtex

@article{f35c9a080e8b4c31ad7fd1c7f8f287b4,
title = "Diabetes mellitus without metformin intake is associated with worse oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma",
abstract = "AIMS: Evidence suggests a detrimental effect of diabetes mellitus (DM) on cancer incidence and outcomes. To date, the effect of DM and its treatment on prognosis in upper tract urothelial carcinoma (UTUC) remains uninvestigated. We tested the hypothesis that DM and metformin use impact oncologic outcomes of patients treated with radical nephroureterectomy (RNU) for UTUC.METHODS: Retrospective analysis of 2492 patients with UTUC treated at 23 institutions with RNU without neoadjuvant therapy. Cox regression models addressed the association of DM and metformin use with disease recurrence, cancer-specific mortality and any-cause mortality.RESULTS: A total of 365 (14.3%) patients had DM and 194 (7.8%) patients used metformin. Within a median follow-up of 36 months, 663 (26.6%) patients experienced disease recurrence, 545 patients (21.9%) died of UTUC and 884 (35.5%) patients died from any cause. Diabetic patients who did not use metformin were at significantly higher risk of disease recurrence and cancer-specific death compared to non-diabetic patients and diabetic patients who used metformin. In multivariable Cox regression analyses, DM treated without metformin was associated with worse recurrence-free survival (HR: 1.44, 95% CI 1.10-1.90, p = 0.009) and cancer-specific mortality (HR: 1.49, 95% CI 1.11-2.00, p = 0.008).CONCLUSIONS: Diabetic UTUC patients without metformin use have significantly worse oncologic outcomes than diabetics who used metformin and non-diabetics. The possible mechanism behind the impact of DM on UTUC biology and the potentially protective effect of metformin need further elucidation.",
keywords = "Aged, Carcinoma, Transitional Cell, Diabetes Mellitus, Female, Follow-Up Studies, Humans, Hypoglycemic Agents, Kaplan-Meier Estimate, Kidney Neoplasms, Lymphatic Metastasis, Male, Metformin, Middle Aged, Neoplasm Grading, Neoplasm Invasiveness, Neoplasm Recurrence, Local, Neoplasm Staging, Nephrectomy, Proportional Hazards Models, Retrospective Studies, Treatment Outcome, Ureteral Neoplasms, Ureteroscopy, Urologic Surgical Procedures",
author = "M Rieken and E Xylinas and L Kluth and Q-D Trinh and Lee, {R K} and H Fajkovic and G Novara and V Margulis and Y Lotan and Martinez-Salamanca, {J I} and K Matsumoto and C Seitz and M Remzi and Karakiewicz, {P I} and Scherr, {D S} and A Briganti and A Kautzky-Willer and A Bachmann and Shariat, {S F} and {UTUC Collaboration}",
note = "Copyright {\textcopyright} 2013 Elsevier Ltd. All rights reserved.",
year = "2014",
month = jan,
day = "1",
doi = "10.1016/j.ejso.2013.09.016",
language = "English",
volume = "40",
pages = "113--120",
journal = "EJSO-EUR J SURG ONC",
issn = "0748-7983",
publisher = "W.B. Saunders Ltd",
number = "1",

}

RIS

TY - JOUR

T1 - Diabetes mellitus without metformin intake is associated with worse oncologic outcomes after radical nephroureterectomy for upper tract urothelial carcinoma

AU - Rieken, M

AU - Xylinas, E

AU - Kluth, L

AU - Trinh, Q-D

AU - Lee, R K

AU - Fajkovic, H

AU - Novara, G

AU - Margulis, V

AU - Lotan, Y

AU - Martinez-Salamanca, J I

AU - Matsumoto, K

AU - Seitz, C

AU - Remzi, M

AU - Karakiewicz, P I

AU - Scherr, D S

AU - Briganti, A

AU - Kautzky-Willer, A

AU - Bachmann, A

AU - Shariat, S F

AU - UTUC Collaboration

N1 - Copyright © 2013 Elsevier Ltd. All rights reserved.

PY - 2014/1/1

Y1 - 2014/1/1

N2 - AIMS: Evidence suggests a detrimental effect of diabetes mellitus (DM) on cancer incidence and outcomes. To date, the effect of DM and its treatment on prognosis in upper tract urothelial carcinoma (UTUC) remains uninvestigated. We tested the hypothesis that DM and metformin use impact oncologic outcomes of patients treated with radical nephroureterectomy (RNU) for UTUC.METHODS: Retrospective analysis of 2492 patients with UTUC treated at 23 institutions with RNU without neoadjuvant therapy. Cox regression models addressed the association of DM and metformin use with disease recurrence, cancer-specific mortality and any-cause mortality.RESULTS: A total of 365 (14.3%) patients had DM and 194 (7.8%) patients used metformin. Within a median follow-up of 36 months, 663 (26.6%) patients experienced disease recurrence, 545 patients (21.9%) died of UTUC and 884 (35.5%) patients died from any cause. Diabetic patients who did not use metformin were at significantly higher risk of disease recurrence and cancer-specific death compared to non-diabetic patients and diabetic patients who used metformin. In multivariable Cox regression analyses, DM treated without metformin was associated with worse recurrence-free survival (HR: 1.44, 95% CI 1.10-1.90, p = 0.009) and cancer-specific mortality (HR: 1.49, 95% CI 1.11-2.00, p = 0.008).CONCLUSIONS: Diabetic UTUC patients without metformin use have significantly worse oncologic outcomes than diabetics who used metformin and non-diabetics. The possible mechanism behind the impact of DM on UTUC biology and the potentially protective effect of metformin need further elucidation.

AB - AIMS: Evidence suggests a detrimental effect of diabetes mellitus (DM) on cancer incidence and outcomes. To date, the effect of DM and its treatment on prognosis in upper tract urothelial carcinoma (UTUC) remains uninvestigated. We tested the hypothesis that DM and metformin use impact oncologic outcomes of patients treated with radical nephroureterectomy (RNU) for UTUC.METHODS: Retrospective analysis of 2492 patients with UTUC treated at 23 institutions with RNU without neoadjuvant therapy. Cox regression models addressed the association of DM and metformin use with disease recurrence, cancer-specific mortality and any-cause mortality.RESULTS: A total of 365 (14.3%) patients had DM and 194 (7.8%) patients used metformin. Within a median follow-up of 36 months, 663 (26.6%) patients experienced disease recurrence, 545 patients (21.9%) died of UTUC and 884 (35.5%) patients died from any cause. Diabetic patients who did not use metformin were at significantly higher risk of disease recurrence and cancer-specific death compared to non-diabetic patients and diabetic patients who used metformin. In multivariable Cox regression analyses, DM treated without metformin was associated with worse recurrence-free survival (HR: 1.44, 95% CI 1.10-1.90, p = 0.009) and cancer-specific mortality (HR: 1.49, 95% CI 1.11-2.00, p = 0.008).CONCLUSIONS: Diabetic UTUC patients without metformin use have significantly worse oncologic outcomes than diabetics who used metformin and non-diabetics. The possible mechanism behind the impact of DM on UTUC biology and the potentially protective effect of metformin need further elucidation.

KW - Aged

KW - Carcinoma, Transitional Cell

KW - Diabetes Mellitus

KW - Female

KW - Follow-Up Studies

KW - Humans

KW - Hypoglycemic Agents

KW - Kaplan-Meier Estimate

KW - Kidney Neoplasms

KW - Lymphatic Metastasis

KW - Male

KW - Metformin

KW - Middle Aged

KW - Neoplasm Grading

KW - Neoplasm Invasiveness

KW - Neoplasm Recurrence, Local

KW - Neoplasm Staging

KW - Nephrectomy

KW - Proportional Hazards Models

KW - Retrospective Studies

KW - Treatment Outcome

KW - Ureteral Neoplasms

KW - Ureteroscopy

KW - Urologic Surgical Procedures

U2 - 10.1016/j.ejso.2013.09.016

DO - 10.1016/j.ejso.2013.09.016

M3 - SCORING: Journal article

C2 - 24113620

VL - 40

SP - 113

EP - 120

JO - EJSO-EUR J SURG ONC

JF - EJSO-EUR J SURG ONC

SN - 0748-7983

IS - 1

ER -