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No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression

BACKGROUND: Non-muscle invasive bladder cancer patients are at high risk for tumour recurrence and progression, hence an intensive follow-up procedure is recommended which is costly. Identification of factors that are associated with the risk of recurrence and progression may enable personalized fol...

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Autores principales: Evers, Jelle, Grotenhuis, Anne J., Aben, Katja K. H., Kiemeney, Lambertus A. L. M., Vrieling, Alina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7094867/
https://www.ncbi.nlm.nih.gov/pubmed/32210471
http://dx.doi.org/10.1371/journal.pone.0229384
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author Evers, Jelle
Grotenhuis, Anne J.
Aben, Katja K. H.
Kiemeney, Lambertus A. L. M.
Vrieling, Alina
author_facet Evers, Jelle
Grotenhuis, Anne J.
Aben, Katja K. H.
Kiemeney, Lambertus A. L. M.
Vrieling, Alina
author_sort Evers, Jelle
collection PubMed
description BACKGROUND: Non-muscle invasive bladder cancer patients are at high risk for tumour recurrence and progression, hence an intensive follow-up procedure is recommended which is costly. Identification of factors that are associated with the risk of recurrence and progression may enable personalized follow-up schedules. Obesity and diabetes mellitus may be associated with a worse prognosis, but the evidence is limited and inconsistent. Our objective was to determine the associations of BMI and diabetes mellitus with risks of recurrence and progression among non-muscle invasive bladder cancer patients. METHODS: A population-based cohort of patients diagnosed with non-muscle invasive bladder cancer between 1995 and 2010 was retrospectively identified from the Netherlands Cancer Registry and invited to participate in the Nijmegen Bladder Cancer Study (n = 1,433). Average weight during adult life, height, and diabetes mellitus diagnosis were self-reported by use of a questionnaire. Clinical follow-up data were retrieved from medical files. Associations were quantified using proportional hazard analyses. For all analyses, minimal adjustment sets were selected using a Directed Acyclic Graph. RESULTS: Fourteen percent of the patients indicated to be diagnosed with diabetes mellitus, and more than half was overweight (45%) or obese (9%). Compared to healthy weight, overweight and obesity were not associated with risk of recurrence (adjusted hazard ratio (HR) = 1.02; 95% confidence interval (CI): 0.86–1.22, and HR = 1.02; 95% CI: 0.76–1.38, respectively) and overall progression (HR = 1.04; 95% CI: 0.74–1.44, and HR = 1.20; 95% CI: 0.69–2.09, respectively). Also, no clear associations of diabetes mellitus with risk of recurrence (HR = 1.22; 95% CI: 0.98–1.54) and overall progression (HR = 1.16; 95% CI: 0.76–1.76) were found. CONCLUSION: Average BMI during adult life and diabetes mellitus were not clearly associated with risk of recurrence or progression in non-muscle invasive bladder cancer. Prospective cohort studies with detailed information on BMI and diabetes mellitus before and after diagnosis are needed to confirm these findings.
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spelling pubmed-70948672020-04-03 No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression Evers, Jelle Grotenhuis, Anne J. Aben, Katja K. H. Kiemeney, Lambertus A. L. M. Vrieling, Alina PLoS One Research Article BACKGROUND: Non-muscle invasive bladder cancer patients are at high risk for tumour recurrence and progression, hence an intensive follow-up procedure is recommended which is costly. Identification of factors that are associated with the risk of recurrence and progression may enable personalized follow-up schedules. Obesity and diabetes mellitus may be associated with a worse prognosis, but the evidence is limited and inconsistent. Our objective was to determine the associations of BMI and diabetes mellitus with risks of recurrence and progression among non-muscle invasive bladder cancer patients. METHODS: A population-based cohort of patients diagnosed with non-muscle invasive bladder cancer between 1995 and 2010 was retrospectively identified from the Netherlands Cancer Registry and invited to participate in the Nijmegen Bladder Cancer Study (n = 1,433). Average weight during adult life, height, and diabetes mellitus diagnosis were self-reported by use of a questionnaire. Clinical follow-up data were retrieved from medical files. Associations were quantified using proportional hazard analyses. For all analyses, minimal adjustment sets were selected using a Directed Acyclic Graph. RESULTS: Fourteen percent of the patients indicated to be diagnosed with diabetes mellitus, and more than half was overweight (45%) or obese (9%). Compared to healthy weight, overweight and obesity were not associated with risk of recurrence (adjusted hazard ratio (HR) = 1.02; 95% confidence interval (CI): 0.86–1.22, and HR = 1.02; 95% CI: 0.76–1.38, respectively) and overall progression (HR = 1.04; 95% CI: 0.74–1.44, and HR = 1.20; 95% CI: 0.69–2.09, respectively). Also, no clear associations of diabetes mellitus with risk of recurrence (HR = 1.22; 95% CI: 0.98–1.54) and overall progression (HR = 1.16; 95% CI: 0.76–1.76) were found. CONCLUSION: Average BMI during adult life and diabetes mellitus were not clearly associated with risk of recurrence or progression in non-muscle invasive bladder cancer. Prospective cohort studies with detailed information on BMI and diabetes mellitus before and after diagnosis are needed to confirm these findings. Public Library of Science 2020-03-25 /pmc/articles/PMC7094867/ /pubmed/32210471 http://dx.doi.org/10.1371/journal.pone.0229384 Text en © 2020 Evers et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Evers, Jelle
Grotenhuis, Anne J.
Aben, Katja K. H.
Kiemeney, Lambertus A. L. M.
Vrieling, Alina
No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression
title No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression
title_full No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression
title_fullStr No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression
title_full_unstemmed No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression
title_short No clear associations of adult BMI and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression
title_sort no clear associations of adult bmi and diabetes mellitus with non-muscle invasive bladder cancer recurrence and progression
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7094867/
https://www.ncbi.nlm.nih.gov/pubmed/32210471
http://dx.doi.org/10.1371/journal.pone.0229384
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