Poor preoperative glycemic control is associated with dismal prognosis after radical nephroureterectomy for upper tract urothelial carcinoma: A Korean multicenter study

Sung-Gu Kang, Eu Chang Hwang, Seung Il Jung, Ho Song Yu, Ho Seok Chung, Taek Won Kang, Dong Deuk Kwon, Jun Eul Hwang, Jun Seok Kim, Joon Hwa Noh, Jae Hyung You, Myung Ki Kim, Tae Hoon Oh, Ill Young Seo, Seung Baik, Chul Sung Kim, Seok Ho Kang, Jun Cheon

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Purpose The purpose of this study is to evaluate the effect of diabetes mellitus (DM) and preoperative glycemic control on prognosis in Korean patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). Materials and Methods A total of 566 patients who underwent RNU at six institutions between 2004 and 2014 were reviewed retrospectively. Kaplan-Meier and Cox regression analyses were performed to assess the association between DM, preoperative glycemic control, and recurrence-free, cancer-specific, and overall survival. Results The median follow-up period was 33.8 months (interquartile range, 41.4 months). A total of 135 patients (23.8%) had DM and 67 patients (11.8%) had poor preoperative glycemic control. Patients with poor preoperative glycemic control had significantly shorter median recurrence-free, cancer-specific, and overall survival than patients with good preoperative glycemic control and non-diabetics (all, p=0.001). In multivariable Cox regression analysis, DM with poor preoperative glycemic control showed association with worse recurrence-free survival (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.31 to 3.90; p=0.003), cancer-specific survival (HR, 2.96; 95% CI, 1.80 to 4.87; p=0.001), and overall survival (HR, 2.13; 95% CI, 1.40 to 3.22; p=0.001). Conclusion Diabetic UTUC patients with poor preoperative glycemic control had significantly worse oncologic outcomes than diabetic UTUC patients with good preoperative glycemic control and non-diabetics. Further investigation is needed to elucidate the exact mechanism underlying the impact of glycemic control on UTUC treatment outcome.

Original languageEnglish
Pages (from-to)1293-1301
Number of pages9
JournalCancer Research and Treatment
Volume48
Issue number4
DOIs
Publication statusPublished - 2016 Jan 1

Fingerprint

Multicenter Studies
Carcinoma
Diabetes Mellitus
Survival
Confidence Intervals
Recurrence
Regression Analysis
Neoplasms

Keywords

  • Diabetes mellitus
  • Prognosis
  • Transitional cell carcinoma

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Poor preoperative glycemic control is associated with dismal prognosis after radical nephroureterectomy for upper tract urothelial carcinoma : A Korean multicenter study. / Kang, Sung-Gu; Hwang, Eu Chang; Jung, Seung Il; Yu, Ho Song; Chung, Ho Seok; Kang, Taek Won; Kwon, Dong Deuk; Hwang, Jun Eul; Kim, Jun Seok; Noh, Joon Hwa; You, Jae Hyung; Kim, Myung Ki; Oh, Tae Hoon; Seo, Ill Young; Baik, Seung; Kim, Chul Sung; Kang, Seok Ho; Cheon, Jun.

In: Cancer Research and Treatment, Vol. 48, No. 4, 01.01.2016, p. 1293-1301.

Research output: Contribution to journalArticle

Kang, S-G, Hwang, EC, Jung, SI, Yu, HS, Chung, HS, Kang, TW, Kwon, DD, Hwang, JE, Kim, JS, Noh, JH, You, JH, Kim, MK, Oh, TH, Seo, IY, Baik, S, Kim, CS, Kang, SH & Cheon, J 2016, 'Poor preoperative glycemic control is associated with dismal prognosis after radical nephroureterectomy for upper tract urothelial carcinoma: A Korean multicenter study', Cancer Research and Treatment, vol. 48, no. 4, pp. 1293-1301. https://doi.org/10.4143/crt.2016.021
Kang, Sung-Gu ; Hwang, Eu Chang ; Jung, Seung Il ; Yu, Ho Song ; Chung, Ho Seok ; Kang, Taek Won ; Kwon, Dong Deuk ; Hwang, Jun Eul ; Kim, Jun Seok ; Noh, Joon Hwa ; You, Jae Hyung ; Kim, Myung Ki ; Oh, Tae Hoon ; Seo, Ill Young ; Baik, Seung ; Kim, Chul Sung ; Kang, Seok Ho ; Cheon, Jun. / Poor preoperative glycemic control is associated with dismal prognosis after radical nephroureterectomy for upper tract urothelial carcinoma : A Korean multicenter study. In: Cancer Research and Treatment. 2016 ; Vol. 48, No. 4. pp. 1293-1301.
@article{4bf8602dd6e4497c88bad64fcc3f3c4b,
title = "Poor preoperative glycemic control is associated with dismal prognosis after radical nephroureterectomy for upper tract urothelial carcinoma: A Korean multicenter study",
abstract = "Purpose The purpose of this study is to evaluate the effect of diabetes mellitus (DM) and preoperative glycemic control on prognosis in Korean patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). Materials and Methods A total of 566 patients who underwent RNU at six institutions between 2004 and 2014 were reviewed retrospectively. Kaplan-Meier and Cox regression analyses were performed to assess the association between DM, preoperative glycemic control, and recurrence-free, cancer-specific, and overall survival. Results The median follow-up period was 33.8 months (interquartile range, 41.4 months). A total of 135 patients (23.8{\%}) had DM and 67 patients (11.8{\%}) had poor preoperative glycemic control. Patients with poor preoperative glycemic control had significantly shorter median recurrence-free, cancer-specific, and overall survival than patients with good preoperative glycemic control and non-diabetics (all, p=0.001). In multivariable Cox regression analysis, DM with poor preoperative glycemic control showed association with worse recurrence-free survival (hazard ratio [HR], 2.26; 95{\%} confidence interval [CI], 1.31 to 3.90; p=0.003), cancer-specific survival (HR, 2.96; 95{\%} CI, 1.80 to 4.87; p=0.001), and overall survival (HR, 2.13; 95{\%} CI, 1.40 to 3.22; p=0.001). Conclusion Diabetic UTUC patients with poor preoperative glycemic control had significantly worse oncologic outcomes than diabetic UTUC patients with good preoperative glycemic control and non-diabetics. Further investigation is needed to elucidate the exact mechanism underlying the impact of glycemic control on UTUC treatment outcome.",
keywords = "Diabetes mellitus, Prognosis, Transitional cell carcinoma",
author = "Sung-Gu Kang and Hwang, {Eu Chang} and Jung, {Seung Il} and Yu, {Ho Song} and Chung, {Ho Seok} and Kang, {Taek Won} and Kwon, {Dong Deuk} and Hwang, {Jun Eul} and Kim, {Jun Seok} and Noh, {Joon Hwa} and You, {Jae Hyung} and Kim, {Myung Ki} and Oh, {Tae Hoon} and Seo, {Ill Young} and Seung Baik and Kim, {Chul Sung} and Kang, {Seok Ho} and Jun Cheon",
year = "2016",
month = "1",
day = "1",
doi = "10.4143/crt.2016.021",
language = "English",
volume = "48",
pages = "1293--1301",
journal = "Cancer Research and Treatment",
issn = "1598-2998",
publisher = "Korean Society for Thoracic and Cardiovascular Surgery",
number = "4",

}

TY - JOUR

T1 - Poor preoperative glycemic control is associated with dismal prognosis after radical nephroureterectomy for upper tract urothelial carcinoma

T2 - A Korean multicenter study

AU - Kang, Sung-Gu

AU - Hwang, Eu Chang

AU - Jung, Seung Il

AU - Yu, Ho Song

AU - Chung, Ho Seok

AU - Kang, Taek Won

AU - Kwon, Dong Deuk

AU - Hwang, Jun Eul

AU - Kim, Jun Seok

AU - Noh, Joon Hwa

AU - You, Jae Hyung

AU - Kim, Myung Ki

AU - Oh, Tae Hoon

AU - Seo, Ill Young

AU - Baik, Seung

AU - Kim, Chul Sung

AU - Kang, Seok Ho

AU - Cheon, Jun

PY - 2016/1/1

Y1 - 2016/1/1

N2 - Purpose The purpose of this study is to evaluate the effect of diabetes mellitus (DM) and preoperative glycemic control on prognosis in Korean patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). Materials and Methods A total of 566 patients who underwent RNU at six institutions between 2004 and 2014 were reviewed retrospectively. Kaplan-Meier and Cox regression analyses were performed to assess the association between DM, preoperative glycemic control, and recurrence-free, cancer-specific, and overall survival. Results The median follow-up period was 33.8 months (interquartile range, 41.4 months). A total of 135 patients (23.8%) had DM and 67 patients (11.8%) had poor preoperative glycemic control. Patients with poor preoperative glycemic control had significantly shorter median recurrence-free, cancer-specific, and overall survival than patients with good preoperative glycemic control and non-diabetics (all, p=0.001). In multivariable Cox regression analysis, DM with poor preoperative glycemic control showed association with worse recurrence-free survival (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.31 to 3.90; p=0.003), cancer-specific survival (HR, 2.96; 95% CI, 1.80 to 4.87; p=0.001), and overall survival (HR, 2.13; 95% CI, 1.40 to 3.22; p=0.001). Conclusion Diabetic UTUC patients with poor preoperative glycemic control had significantly worse oncologic outcomes than diabetic UTUC patients with good preoperative glycemic control and non-diabetics. Further investigation is needed to elucidate the exact mechanism underlying the impact of glycemic control on UTUC treatment outcome.

AB - Purpose The purpose of this study is to evaluate the effect of diabetes mellitus (DM) and preoperative glycemic control on prognosis in Korean patients with upper tract urothelial carcinoma (UTUC) who underwent radical nephroureterectomy (RNU). Materials and Methods A total of 566 patients who underwent RNU at six institutions between 2004 and 2014 were reviewed retrospectively. Kaplan-Meier and Cox regression analyses were performed to assess the association between DM, preoperative glycemic control, and recurrence-free, cancer-specific, and overall survival. Results The median follow-up period was 33.8 months (interquartile range, 41.4 months). A total of 135 patients (23.8%) had DM and 67 patients (11.8%) had poor preoperative glycemic control. Patients with poor preoperative glycemic control had significantly shorter median recurrence-free, cancer-specific, and overall survival than patients with good preoperative glycemic control and non-diabetics (all, p=0.001). In multivariable Cox regression analysis, DM with poor preoperative glycemic control showed association with worse recurrence-free survival (hazard ratio [HR], 2.26; 95% confidence interval [CI], 1.31 to 3.90; p=0.003), cancer-specific survival (HR, 2.96; 95% CI, 1.80 to 4.87; p=0.001), and overall survival (HR, 2.13; 95% CI, 1.40 to 3.22; p=0.001). Conclusion Diabetic UTUC patients with poor preoperative glycemic control had significantly worse oncologic outcomes than diabetic UTUC patients with good preoperative glycemic control and non-diabetics. Further investigation is needed to elucidate the exact mechanism underlying the impact of glycemic control on UTUC treatment outcome.

KW - Diabetes mellitus

KW - Prognosis

KW - Transitional cell carcinoma

UR - http://www.scopus.com/inward/record.url?scp=84996835410&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84996835410&partnerID=8YFLogxK

U2 - 10.4143/crt.2016.021

DO - 10.4143/crt.2016.021

M3 - Article

C2 - 27034146

AN - SCOPUS:84996835410

VL - 48

SP - 1293

EP - 1301

JO - Cancer Research and Treatment

JF - Cancer Research and Treatment

SN - 1598-2998

IS - 4

ER -