KEY TAKEAWAYS
- The study aimed to explore the link between diabetes and outcomes in patients with BC undergoing RARC.
- Diabetes worsens outcomes in patients with BC undergoing RARC; future research should explore this interaction.
Gabriele Tuderti and the team aimed to examine how diabetes affects oncological outcomes in patients with muscle-invasive (MI) or high-risk non-muscle invasive (NMI) bladder cancer (BC) who underwent robot-assisted radical cystectomy with intracorporeal urinary diversion (RARC).
The study queried an IRB-approved, multi-institutional BC database, including patients who underwent RARC from January 2013 to June 2023. Patients were categorized by diabetes status.
Researchers compared baseline, clinical, perioperative, and pathologic data using Chi-square and Student t tests for categorical and continuous variables, respectively. They used the Kaplan-Meier method and Cox regression analyses to evaluate the impact of diabetes on oncological outcomes.
Of 547 consecutive patients, 97 (17.7%) had diabetes.The 2 groups had similar preoperative features, except for ASA score (P= 0.01) and hypertension rates (P< 0.001). No significant differences were found in perioperative complications, pT stage, pN stage, or surgical margin status (all P> 0.12).
Patients with diabetes had significantly lower 5-year disease-free survival (DFS) (44.6% vs. 63.3%, P= 0.007), 5-year cancer-specific survival (CSS) (45.1% vs. 70.1%, P= 0.001), and 5-year overall survival (OS) (39.9% vs. 63.8%, P= 0.001).
Multivariable Cox regression analyses identified diabetes as an independent predictor of worse CSS (HR 2.1; P= 0.001) and OS (HR 2.05; P< 0.001).
The study concluded that among patients with BC who underwent RARC, those with diabetes experienced worse oncological outcomes compared to those without diabetes. Diabetes was identified as an independent negative predictor of cancer-specific and OS. Future prospective studies are needed to explore the mechanisms linking diabetes with BC outcomes.
No external funding was provided.
Source: https://pubmed.ncbi.nlm.nih.gov/39133312/
Tuderti G, Chiacchio G, Mastroianni R, et al. (2024). “Impact of diabetes mellitus on oncologic outcomes in patients receiving robot-assisted radical cystectomy for bladder cancer.” World J Urol. 2024;42(1):479. Published 2024 Aug 12. doi:10.1007/s00345-024-05178-9
