Poor glycemic control is associated with worse outcomes among patients who receive treatment for non-muscle-invasive bladder cancer (NMIBC), investigators reported at the Canadian Urological Association’s 74th Annual Meeting in Quebec City.
Myung Soo Kim, MD, and colleagues at the Chonnam National University Medical School, in Gwangju, Korea, studied 617 patients with NMIBC: 499 without diabetes mellitus (DM, group 1), 58 patients with DM and preoperative hemoglobin A1c (HbA1c) levels below 7% (group 2), and 60 patients with DM and HbA1c levels of 7% or higher (group 3). The investigators performed propensity score matching using variables related to tumor progression, including sex, age, body mass index, and tumor grade, size, pathologic stage, multiplicity.
Groups 1 and 2 did not differ significantly with respect to tumor characteristics and tumor recurrence and progression rates. Group 3, however, had a significantly higher proportion of patients with tumor multiplicity greater than 3 (58.3% vs 42.4%) and pathologic stage higher than T1 (43.3% vs 30.9%) compared with group 1. Group 3 also had a higher tumor recurrence rate (48.3% vs 33.0) and tumor progression rate (31.6% vs 11.4%).
After propensity score matching between group 1 and group 3, Dr Kim’s team found no significant differences in the characteristics and recurrence rates between groups 1 and 3, but the tumor progression rate was significantly higher in group 3 (31.6% vs 15.8%). Kaplan-Meier analysis demonstrated significantly improved progression-free survival in group 3 compared with group 1.
Kim MS, Son S, Kim TH, et al. Impact of glycemic control on the recurrence and progression of non-muscle-invasive bladder cancer in patients with diabetes mellitus. Presented at the Canadian Urological Association’s 74 Annual Meeting in Quebec City. Poster MP-2.11.