Poor Preoperative Glycemic Control Is Associated with Dismal Prognosis after Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma: A Korean Multicenter Study
- Authors
- 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
- Issue Date
- 10월-2016
- Publisher
- KOREAN CANCER ASSOCIATION
- Keywords
- Diabetes mellitus; Transitional cell carcinoma; Prognosis
- Citation
- CANCER RESEARCH AND TREATMENT, v.48, no.4, pp.1293 - 1301
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- CANCER RESEARCH AND TREATMENT
- Volume
- 48
- Number
- 4
- Start Page
- 1293
- End Page
- 1301
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/87261
- DOI
- 10.4143/crt.2016.021
- ISSN
- 1598-2998
- 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.
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