title: Diabetes is an Important Risk Factor for Metastasis in Non- Muscle-Invasive Bladder Cancer.
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).
  
  
  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.
authors.affiliation: Urology, Ataturk Training and Research Hospital, Katip Celebi University, Izmir, Turkey E-mail : drozanhorsanali@yahoo.com.
authors.forename: Kutan
authors.initials: K
authors.lastname: Ozer
authors.forename: Mustafa Ozan
authors.initials: MO
authors.lastname: Horsanali
authors.forename: Sacit Nuri
authors.initials: SN
authors.lastname: Gorgel
authors.forename: Emin
authors.initials: E
authors.lastname: Ozbek
mesh_terms: D000368:Aged; D048909:Diabetes Complications / Q000473:pathology*; D003920:Diabetes Mellitus / Q000473:pathology*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000473:pathology*; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging / Q000379:methods; D012189:Retrospective Studies; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000209:etiology* / Q000473:pathology*