{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T20:06:46Z","timestamp":1793390806759,"version":"4.5.0"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T00:00:00Z","timestamp":1782777600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec>\n                    <jats:title>Background\/objectives<\/jats:title>\n                    <jats:p>Urothelial carcinoma (UC) is a prevalent malignancy of the urinary system, associated with substantial morbidity and mortality. Metabolic syndrome (MetS), comprising obesity, hypertension, dyslipidemia, and hyperglycemia, has been implicated in cancer development, but its prognostic impact in UC remains unclear. This study aimed to explore the association between MetS and survival outcomes in UC patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A single-center retrospective study was conducted, analyzing 112 patients with UC, diagnosed between January 2018 and February 2024. Patients were categorized based on the presence of MetS (\u2265 3 criteria) or its individual components. Overall survival (OS) and progression-free survival (PFS) were evaluated using Kaplan\u2013Meier estimates and Cox proportional hazard regression models, adjusting for disease stage and relevant covariates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The cohort was predominantly male (82.1%), with a median age of 71.9 years (IQR 65.8-79). MetS was present in 49 patients (43.8%). After adjustment for stage, MetS was associated with poorer OS (HR 2.04, p=0.018) and PFS (HR 2.13, p=0.024). In multivariate analysis, MetS independently predicted OS (HR 2.27, p=0.038). Diabetes was the strongest individual predictor of adverse outcomes (adjusted HR for OS 3.33, p=0.001; PFS 3.35, p=0.002). Hypertension also independently predicted worse OS (HR 1.96, p=0.039), whereas obesity and dyslipidemia were not associated with survival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>MetS and its components, particularly diabetes and hypertension, were associated with poorer survival outcomes in patients with UC. Further prospective studies are required to determine whether optimization of metabolic health can improve oncological outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fonc.2026.1858817","type":"journal-article","created":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:24:39Z","timestamp":1782793479000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["The impact of metabolic syndrome on survival outcomes in urothelial carcinoma: a retrospective cohort study"],"prefix":"10.3389","volume":"16","author":[{"given":"Aspasia","family":"Manta","sequence":"first","affiliation":[{"name":"Endocrine Unit, Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afroditi","family":"Roumpou","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Gerogianni","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roubini","family":"Zakopoulou","sequence":"additional","affiliation":[{"name":"Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimon","family":"Tzannis","sequence":"additional","affiliation":[{"name":"Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areti","family":"Mamali","sequence":"additional","affiliation":[{"name":"Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Malamatini","sequence":"additional","affiliation":[{"name":"Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantina","family":"Kakogianni","sequence":"additional","affiliation":[{"name":"Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aristotelis","family":"Bamias","sequence":"additional","affiliation":[{"name":"Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melpomeni","family":"Peppa","sequence":"additional","affiliation":[{"name":"Endocrine Unit, Second Propaedeutic Department of Internal Medicine, Research Institute and Diabetes Center, Attikon University Hospital, School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]},{"name":"Third Department of Internal Medicine, Sotiria General Hospital for Chest Diseases School of Medicine, National and Kapodistrian University of Athens","place":["Athens, Greece"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,6,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"7","DOI":"10.3322\/caac.21708","article-title":"Cancer statistics, 2022","volume":"72","author":"Siegel","year":"2022","journal-title":"CA Cancer J Clin"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1016\/j.euo.2022.10.003","article-title":"Epidemiology, screening, and prevention of bladder cancer","volume":"5","author":"Lobo","year":"2022","journal-title":"Eur Urol Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2023.05.005","article-title":"Definition and diagnosis of oligometastatic bladder cancer: A Delphi consensus study endorsed by the European Association of Urology, European Society for Radiotherapy and Oncology, and European Society of Medical Oncology Genitourinary Faculty","volume":"84","author":"Bamias","year":"2023","journal-title":"Eur Urol"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph21070954","article-title":"Risk factors associated with urothelial bladder cancer","volume":"21","author":"Alouini","year":"2024","journal-title":"Int J Environ Res Public Health"},{"key":"B5","doi-asserted-by":"publisher","first-page":"e3502","DOI":"10.1002\/dmrr.3502","article-title":"Metabolic syndrome and cardiovascular diseases: Going beyond traditional risk factors","volume":"38","author":"Silveira Rossi","year":"2022","journal-title":"Diabetes Metab Res Rev"},{"key":"B6","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1159\/000447229","article-title":"The association between metabolic syndrome and high-stage primary urothelial carcinoma of the bladder","volume":"12","author":"Nagase","year":"2018","journal-title":"Curr Urol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"720","DOI":"10.1186\/s12885-015-1769-9","article-title":"Metabolic syndrome and the risk of urothelial carcinoma of the bladder: a case-control study","volume":"15","author":"Montella","year":"2015","journal-title":"BMC Cancer"},{"key":"B8","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1186\/s12894-020-00684-5","article-title":"Effect of diabetes mellitus and glycemic control on the prognosis of non-muscle invasive bladder cancer: a retrospective study","volume":"20","author":"Huang","year":"2020","journal-title":"BMC Urol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21388","article-title":"The eighth edition <scp>AJCC<\/scp> cancer staging manual: Continuing to build a bridge from a population\u2010based to a more \u201cpersonalized\u201d approach to cancer staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J Clin"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1159\/000503095","article-title":"Performance status assessment by using ECOG (Eastern Cooperative Oncology Group) score for cancer patients by oncology healthcare professionals","volume":"12","author":"Azam","year":"2019","journal-title":"Case Rep Oncol"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.2147\/IJGM.S346972","article-title":"Metabolic syndrome is an independent risk factor for Fuhrman grade and TNM stage of renal clear cell carcinoma","volume":"15","author":"Zhang","year":"2022","journal-title":"Int J Gen Med"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1007\/s12672-017-0289-2","article-title":"Metabolic syndrome negatively impacts the outcome of localized renal cell carcinoma","volume":"8","author":"Kriegmair","year":"2017","journal-title":"Horm Cancer"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000047247","article-title":"Impact of metabolic syndrome and its components on the tumor aggressiveness of renal cell carcinoma","volume":"105","author":"Dogan","year":"2026","journal-title":"Medicine"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.1007\/s10147-020-01834-3","article-title":"The metabolic syndrome is associated with the risk of urothelial carcinoma from a health examination database","volume":"26","author":"Lee","year":"2021","journal-title":"Int J Clin Oncol"},{"key":"B15","doi-asserted-by":"publisher","first-page":"236","DOI":"10.1186\/s12957-015-0631-5","article-title":"The association between metabolic syndrome and the risk of urothelial carcinoma of the bladder: a case-control study in China","volume":"13","author":"Xu","year":"2015","journal-title":"World J Surg Oncol"},{"key":"B16","doi-asserted-by":"publisher","first-page":"291.e19","DOI":"10.1016\/j.urolonc.2018.12.005","article-title":"Metabolic syndrome and upper tract urothelial carcinoma: A retrospective analysis from a large Chinese cohort","volume":"37","author":"Xu","year":"2019","journal-title":"Urologic Oncol Semin Original Investigations"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.2147\/OTT.S102424","article-title":"The evaluation of the association between the metabolic syndrome and tumor grade and stage of bladder cancer in a Chinese population","volume":"9","author":"Sha","year":"2016","journal-title":"Onco Targets Ther"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.2147\/cmar.s181178","article-title":"The association between metabolic syndrome and bladder cancer susceptibility and prognosis: an updated comprehensive evidence synthesis of 95 observational studies involving 97,795,299 subjects","volume":"10","author":"Peng","year":"2018","journal-title":"Cancer Manag Res"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1111\/iju.12901","article-title":"Association between diabetes mellitus and oncological outcomes in bladder cancer patients undergoing radical cystectomy","volume":"22","author":"Oh","year":"2015","journal-title":"Int J Urol"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.741145","article-title":"The impact of diabetes on the prognosis of upper tract urothelial carcinoma after radical nephroureterectomy: A systematic review and meta-analysis","volume":"11","author":"Gao","year":"2021","journal-title":"Front Oncol"},{"key":"B21","doi-asserted-by":"publisher","first-page":"49.e7","DOI":"10.1016\/j.urolonc.2013.07.006","article-title":"Effect of diabetes mellitus and metformin use on oncologic outcomes of patients treated with radical cystectomy for urothelial carcinoma","volume":"32","author":"Rieken","year":"2014","journal-title":"Urologic Oncol Semin Original Investigations"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2020.613366","article-title":"Metabolic syndrome and risk of upper tract urothelial carcinoma: A case-control study from Surveillance, Epidemiology and End Results-Medicare-Linked Database","volume":"10","author":"Lu","year":"2021","journal-title":"Front Oncol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.3721","article-title":"Association between blood pressure and BMI with bladder cancer risk and mortality in 340,000 men in three Swedish cohorts","volume":"10","author":"Teleka","year":"2021","journal-title":"Cancer Med"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10061074","article-title":"Association of hypertension and organ-specific cancer: A meta-analysis","volume":"10","author":"Connaughton","year":"2022","journal-title":"Healthcare"},{"key":"B25","doi-asserted-by":"publisher","first-page":"18336","DOI":"10.1038\/s41598-022-23225-6","article-title":"Interaction between blood pressure and genetic risk score for bladder cancer, and risk of urothelial carcinoma in men","volume":"12","author":"Teleka","year":"2022","journal-title":"Sci Rep"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.3389\/fnut.2024.1433632","article-title":"Navigating the obesity paradox in bladder cancer prognosis\u2014insights from the Taiwan National Health Insurance System Database","volume":"11","author":"Tseng","year":"2024","journal-title":"Front Nutr"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1080\/09637486.2018.1529147","article-title":"Dose-response relation between serum total cholesterol levels and overall cancer risk: evidence from 12 prospective studies involving 1,926,275 participants","volume":"70","author":"Wu","year":"2019","journal-title":"Int J Food Sci Nutr"},{"key":"B28","doi-asserted-by":"publisher","first-page":"103","DOI":"10.1186\/s13045-023-01498-2","article-title":"Lipid metabolic reprogramming in tumor microenvironment: from mechanisms to therapeutics","volume":"16","author":"Jin","year":"2023","journal-title":"J Hematol Oncol"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.23192","article-title":"Chronic inflammation and oxidative stress in human carcinogenesis","volume":"121","author":"Federico","year":"2007","journal-title":"Int J Cancer"},{"key":"B30","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1079\/PNS200070","article-title":"Energy balance and cancer: the role of insulin and insulin-like growth factor-I","volume":"60","author":"Kaaks","year":"2001","journal-title":"Proc Nutr Soc"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcte.2024.100382","article-title":"The association of neutrophil-to-lymphocyte ratio with metabolic syndrome in U.S. adults: Findings from the 1999\u20132018 National Health and Nutrition Examination survey","volume":"39","author":"Sarrafan-Chaharsoughi","year":"2025","journal-title":"J Clin Transl Endocrinol"},{"key":"B32","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/s12933-025-02629-4","article-title":"Association between the systemic immune-inflammation index and metabolic syndrome and its components: results from the multi-ethnic study of atherosclerosis (MESA)","volume":"24","author":"Ramezankhani","year":"2025","journal-title":"Cardiovasc Diabetol"},{"key":"B33","doi-asserted-by":"publisher","first-page":"605","DOI":"10.56434\/j.arch.esp.urol.20237608.75","article-title":"Exploring the shared gene signatures and molecular mechanisms between bladder urothelial carcinoma and metabolic syndrome","volume":"76","author":"Li","year":"2023","journal-title":"Arch Esp Urol"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1858817\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T04:24:40Z","timestamp":1782793480000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2026.1858817\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,30]]},"references-count":33,"alternative-id":["10.3389\/fonc.2026.1858817"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2026.1858817","relation":{},"ISSN":["2234-943X"],"issn-type":[{"value":"2234-943X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,30]]},"article-number":"1858817"}}