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http://dx.doi.org/10.7314/APJCP.2016.17.1.105

Diabetes is an Important Risk Factor for Metastasis in Non-Muscle-Invasive Bladder Cancer  

Ozer, Kutan (Urology, Ataturk Training and Research Hospital, Katip Celebi University)
Horsanali, Mustafa Ozan (Urology, Ataturk Training and Research Hospital, Katip Celebi University)
Gorgel, Sacit Nuri (Urology, Ataturk Training and Research Hospital, Katip Celebi University)
Ozbek, Emin (Urology, Istanbul Training and Research Hospital)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.17, no.1, 2016 , pp. 105-108 More about this Journal
Abstract
Background: Epidemiological evidence indicates that individuals with diabetes mellitus (DM) may have a modestly increased risk of bladder cancer. In the present study, we aimed to show any association between DM and risk of metastasis in patients with non-muscle-invasive bladder cancer (NMIBC). Materials and Methods: We retrospectively analyzed 698 patients between January 2007 and December 2014 who were diagnosed with and underwent transurethral resection of bladder tumors (TUR-BT). Comparisons of means was conducted by independent samples t test, and relations between categorical variables were investigated by non-parametric chi-square test. A p value of 0.05 was accepted as statistically significant in comparisons. Results: We analyzed 418 patients with non muscle invasive bladder cancer. 123 of whom were diabetic and 295 non-diabetic. In diabetic patients, 13 were N1 stage and 11 M1 stage. When compared with non diabetic patients that was statistically significant (p<0.001). TNM stages were more advanced in diabetic patients (p<0.001), but concurrent CIS (p=0.1) and squamous metaplasia did not significantly differ between diabetic and non-diabetic cases (p=1). Conclusions: Diabetic patients with non-muscle-invasive bladder cancer may suffer metastases earlier than expected although they are non invasive. Therefore such patients must be followed-up carefully and early cystectomy decision may be necessary. Further prospective studies with more patients are needed to confirm these findings.
Keywords
Bladder cancer; diabetes mellitus; non-muscle-invasive; metastasis risk;
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1 Poulson J (1997). The management of diabetes in patients with advanced cancer. J Pain Symptom Manage, 13, 339-34.   DOI
2 Radinsky R (1991). Growth factors and their receptors in metastasis. Semin Cancer Biol, 2, 169-77.
3 Richardson LC, Pollack LA (2005). Therapy insight, influence of type 2 diabetes on the development, treatment and outcomes of cancer. Nat Clin Pract Oncol, 2, 48-53.   DOI
4 Rieken M, Xylinas E, Kluth L, et al (2013). Association of diabetes mellitus and metformin use with oncological outcomes of patients with non-muscle invasive bladder cancer. BJU Int, 112, 1105-12.   DOI
5 Rodel C, Grabenbauer GG, Kuhn R, et al (2002). Combinedmodality treatment and selective organ preservation in invasive bladder cancer, long-term results. J Clin Oncol, 20, 3061-71.   DOI
6 Rucci N, Sanita P, Angelucci A (2011). Roles of metalloproteases in metastatic niche. Curr Mol Med, 11, 609-22.   DOI
7 Sasaki Y1, Oi H, Oyama T, et al (2013). Non-muscle invasive bladder cancer with multiple bone metastasis without local invasion, a case report. Hinyokika Kiyo, 59, 669-72.
8 Schenk-Braat, EA, Bangma, CH, (2005). Immunotherapy for superficial bladder cancer. Cancer Immunol Immunother, 54, 414-423.   DOI
9 Siegel R, Naishadham D, Jemal A (2012). Cancer statistics, 2012. CA Cancer J Clin, 62, 10-29.   DOI
10 Stiles CD, Capone GT, Scher CD, et al (1979). Dual control of cell growth by somatomedins and platelet-derived growth factor. Proc Natl Acad Sci USA, 76, 1279-83.   DOI
11 Sylvester RJ, van der Meijden AP, Oosterlinck W, et al (2006). Predicting recurrence and progression in individual patients with stage TaT1 bladder cancer using EORTC risk tables, a combined analysis of 2596 patients from seven EORTC trials. Eur Urol, 49, 466-77.   DOI
12 Tripathi A, Folsom AR, Anderson KE (2002). Risk factors for urinary bladder carcinoma in postmenopausal women. the iowa women's health study. Cancer, 95, 2316-23.   DOI
13 Tuncer M, Faydaci G, Altin G, et al (2014). Metastasis of nonmuscle- invasive bladder cancer into the thyroid gland, a literature review accompanied by a rare case. Korean J Urol, 55, 222-5.   DOI
14 Turati F, Polesel J, Di Maso M, et al (2015). Diabetes mellitus and the risk of bladder cancer, an Italian case-control study. Br J Cancer, 1-4.
15 Vigneri P, Frasca F, Sciacca L, et al (2009). Diabetes and cancer. Endocr Relat Cancer, 16, 1103-23.   DOI
16 Zeegers MP, Tan FE, Dorant E, et al (2000). The impact of characteristics of cigarette smoking on urinary tract cancer risk, a meta-analysis of epidemiologic studies. Cancer, 89, 630-9   DOI
17 Zhang T, Guo P, Zhang Y, et al (2013). The antidiabetic drug metformin inhibits the proliferation of bladder cancer cells in Vitro and in Vivo. Int J Mol Sci, 14, 24603-18.   DOI
18 Zhou G, Myers R, Li Y, et al (2001). Role of AMP-activated protein kinase in mechanism of metforminaction. J Clin Invest, 108, 1167-74.   DOI
19 Aaronson S (1991). Growth factors and cancer. Sci, 254, 1146-53.   DOI
20 Amalinei C, Caruntu ID, Giusca SE, et al (2010). Matrix metalloproteinases involvement in pathologic conditions. Rom J Morphol Embryol, 51, 215-28.
21 Brausi M, Collette L, Kurth K, et al (2002). EORTC genitourinary tract cancer collaborative group. variability in the recurrence rate at first follow-up cystoscopy after TUR in stage Ta T1 transitional cell carcinoma of the bladder, a combined analysis of seven EORTC studies. Eur Urol, 41, 523-31.   DOI
22 Attia N, Caprio S, Jones TW, et al (1999). Changes in free insulin-like growth factor-1 and leptin concentrations during acute metabolic decompensation in insulin withdrawn patients with type 1 diabetes. J Clin Endocrinol Metab, 84, 2324-8.
23 Bischoff CJ, Clark PE (2009). Bladder cancer. Curr Opin Oncol, 21, 272-7.   DOI
24 Boyle JG, Salt IP, McKay GA (2010). Metformin action on AMPactivated protein kinase, A translational research approach to understanding a potential new therapeutic target. Diabet Med, 27, 1097-106.   DOI
25 Chen HC, Chen CA, Guh JY, et al (2000). Altering expression of alpha3beta1 integrin on podocytes of human and rats with diabetes. Life Sci, 67, 2345-53.   DOI
26 Coughlin SS, Calle EE, Teras LR, et al (2004). Diabetes mellitus as a predictor of cancer mortality in a large cohort of US adults. Am J Epidemiol, 159, 1160-7.   DOI
27 Divrik RT, Sahin AF, Yildirim U, et al (2010). Impact of routine second transurethral resection on the long-term outcome of patients with newly diagnosed pT1 urothelial carcinoma with respect to recurrence, progression rate, and diseasespecific survival, a prospective randomised clinical trial. Eur Urol, 58, 185-90.   DOI
28 Hong JH (2015). Early isolated bone metastases without local recurrence in non-muscle invasive bladder cancer. Int J Surg Case Rep, 10, 41-4.   DOI
29 Jee SH, Ohrr H, Sull JW, et al (2005). Fastingserum glucose level and cancer risk in Korean men and women. JAMA, 293, 194-202.   DOI
30 Hwang EC, Kim YJ, Hwang IS, et al (2011). Impact of diabetesmellitus on recurrence and progression in patients with nonmuscle invasive bladder carcinoma, A retrospective cohort study. Int J Urol, 18, 769-76.   DOI
31 Larsson SC, Orsini N, Brismar K, et al (2006). Diabetes mellitus and risk of bladder cancer, a meta-analysis. Diabetologia, 49, 2819-23.   DOI
32 Larsson SC (2008). Diabetes mellitus, body size and bladder cancer risk in a prospective study of Swedish men. Eur J Cancer, 44, 2655-60.   DOI
33 Lipponen PK, Eskelinen MJ (1995). Reduced expression of E-cadherin is related to invasive disease and frequent recurrence in bladder cancer. J Cancer Res Clin Oncol, 121, 303-8   DOI
34 MacKenzie T, Zens MS, Ferrara A, et al (2011). Diabetes and risk of bladder cancer, evidence from a case-control study in New England. Cancer, 117, 1552-6.   DOI
35 Mamtani R, Pfanzelter N, Haynes K, et al (2014). Incidence of bladder cancer in patients with type 2 diabetes treated with metformin or sulfonylureas. Diabetes Care, 37, 1910-7.   DOI
36 Mariappan P, Zachou A, Grigor KM (2010). Detrusor muscle in the first, apparently complete transurethral resection of bladder tumour specimen is a surrogate marker of resection quality, predicts risk of early recurrence, and is dependent on operator experience. Eur Urol, 57, 843-9.   DOI
37 Plowman GD, Green JM, McDonald VL, et al (1981). The amphiregulin gene encodes a novel epidermal growth factor-related protein with tumor-inhibitory activity. Mol Cell Biol, 10, 1969-81.