Impact of smoking on outcomes of patients with a history of recurrent nonmuscle invasive bladder cancer

Michael Rink, Evanguelos Xylinas, Marko Babjuk, Jens Hansen, Armin Pycha, Evi Comploj, Yair Lotan, Maxine Sun, Pierre I. Karakiewicz, Joual Abdennabi, Harun Fajkovic, Wolfgang Loidl, Felix K. Chun, Margit Fisch, Douglas S. Scherr, Shahrokh F. Shariat

Research output: Contribution to journalArticle

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Abstract

Purpose: We investigated the effects of cigarette smoking status, cumulative exposure and time from cessation on disease recurrence and progression in patients with a history of recurrent nonmuscle invasive bladder cancer. Materials and Methods: A total of 390 patients with recurrent nonmuscle invasive bladder cancer were treated with transurethral resection of the bladder, of whom 159 (41%) received instillation therapy immediately postoperatively and 73 (19%) received adjuvant intravesical immunotherapy or chemotherapy. Smoking history included smoking status, number of cigarettes per day, smoking duration in years and years since smoking cessation. Cumulative smoking exposure was categorized as light short-term - 19 or fewer cigarettes per day and 19.9 years or less, moderate - all combinations except light short-term and heavy long-term, and heavy long-term - 20 or greater cigarettes per day and 20 years or greater. Results: A total of 91 (23%), 192 (49%) and 107 patients (28%) were never, former and current smokers, respectively. Of ever smokers 56 (19%), 156 (52%) and 87 (29%) were light short-term, moderate and heavy long-term smokers, respectively. There was no difference in the risk of disease recurrence and progression among current, former and never smokers. On univariable analyses in ever smokers the risk of disease recurrence and progression increased with augmented smoking intensity (p ≤0.015), duration (p <0.001) and cumulative exposure (p <0.001). On multivariable analyses cumulative smoking exposure was an independent risk factor for disease recurrence and progression (p ≤0.003). Smoking cessation greater than 10 years before treatment was independently associated with decreased disease recurrence compared to current smoking (HR 0.4, p <0.001). In addition, current smokers had worse survival than former smokers, who in turn had worse survival than never smokers (p >0.05). Conclusions: There is a dose-response relationship of smoking exposure and smoking cessation with disease recurrence and progression in ever smokers with a history of recurrent nonmuscle invasive bladder cancer. These findings support counseling on smoking cessation benefits.

Original languageEnglish (US)
Pages (from-to)2120-2127
Number of pages8
JournalJournal of Urology
Volume188
Issue number6
DOIs
StatePublished - Dec 2012

Fingerprint

Urinary Bladder Neoplasms
Smoking
Disease Progression
Smoking Cessation
Tobacco Products
Recurrence
Light
Immunotherapy
Counseling
Urinary Bladder
History
Drug Therapy

Keywords

  • carcinoma
  • smoking
  • survival
  • urinary bladder
  • urothelium

ASJC Scopus subject areas

  • Urology

Cite this

Rink, M., Xylinas, E., Babjuk, M., Hansen, J., Pycha, A., Comploj, E., ... Shariat, S. F. (2012). Impact of smoking on outcomes of patients with a history of recurrent nonmuscle invasive bladder cancer. Journal of Urology, 188(6), 2120-2127. https://doi.org/10.1016/j.juro.2012.08.029

Impact of smoking on outcomes of patients with a history of recurrent nonmuscle invasive bladder cancer. / Rink, Michael; Xylinas, Evanguelos; Babjuk, Marko; Hansen, Jens; Pycha, Armin; Comploj, Evi; Lotan, Yair; Sun, Maxine; Karakiewicz, Pierre I.; Abdennabi, Joual; Fajkovic, Harun; Loidl, Wolfgang; Chun, Felix K.; Fisch, Margit; Scherr, Douglas S.; Shariat, Shahrokh F.

In: Journal of Urology, Vol. 188, No. 6, 12.2012, p. 2120-2127.

Research output: Contribution to journalArticle

Rink, M, Xylinas, E, Babjuk, M, Hansen, J, Pycha, A, Comploj, E, Lotan, Y, Sun, M, Karakiewicz, PI, Abdennabi, J, Fajkovic, H, Loidl, W, Chun, FK, Fisch, M, Scherr, DS & Shariat, SF 2012, 'Impact of smoking on outcomes of patients with a history of recurrent nonmuscle invasive bladder cancer', Journal of Urology, vol. 188, no. 6, pp. 2120-2127. https://doi.org/10.1016/j.juro.2012.08.029
Rink, Michael ; Xylinas, Evanguelos ; Babjuk, Marko ; Hansen, Jens ; Pycha, Armin ; Comploj, Evi ; Lotan, Yair ; Sun, Maxine ; Karakiewicz, Pierre I. ; Abdennabi, Joual ; Fajkovic, Harun ; Loidl, Wolfgang ; Chun, Felix K. ; Fisch, Margit ; Scherr, Douglas S. ; Shariat, Shahrokh F. / Impact of smoking on outcomes of patients with a history of recurrent nonmuscle invasive bladder cancer. In: Journal of Urology. 2012 ; Vol. 188, No. 6. pp. 2120-2127.
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abstract = "Purpose: We investigated the effects of cigarette smoking status, cumulative exposure and time from cessation on disease recurrence and progression in patients with a history of recurrent nonmuscle invasive bladder cancer. Materials and Methods: A total of 390 patients with recurrent nonmuscle invasive bladder cancer were treated with transurethral resection of the bladder, of whom 159 (41{\%}) received instillation therapy immediately postoperatively and 73 (19{\%}) received adjuvant intravesical immunotherapy or chemotherapy. Smoking history included smoking status, number of cigarettes per day, smoking duration in years and years since smoking cessation. Cumulative smoking exposure was categorized as light short-term - 19 or fewer cigarettes per day and 19.9 years or less, moderate - all combinations except light short-term and heavy long-term, and heavy long-term - 20 or greater cigarettes per day and 20 years or greater. Results: A total of 91 (23{\%}), 192 (49{\%}) and 107 patients (28{\%}) were never, former and current smokers, respectively. Of ever smokers 56 (19{\%}), 156 (52{\%}) and 87 (29{\%}) were light short-term, moderate and heavy long-term smokers, respectively. There was no difference in the risk of disease recurrence and progression among current, former and never smokers. On univariable analyses in ever smokers the risk of disease recurrence and progression increased with augmented smoking intensity (p ≤0.015), duration (p <0.001) and cumulative exposure (p <0.001). On multivariable analyses cumulative smoking exposure was an independent risk factor for disease recurrence and progression (p ≤0.003). Smoking cessation greater than 10 years before treatment was independently associated with decreased disease recurrence compared to current smoking (HR 0.4, p <0.001). In addition, current smokers had worse survival than former smokers, who in turn had worse survival than never smokers (p >0.05). Conclusions: There is a dose-response relationship of smoking exposure and smoking cessation with disease recurrence and progression in ever smokers with a history of recurrent nonmuscle invasive bladder cancer. These findings support counseling on smoking cessation benefits.",
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AU - Rink, Michael

AU - Xylinas, Evanguelos

AU - Babjuk, Marko

AU - Hansen, Jens

AU - Pycha, Armin

AU - Comploj, Evi

AU - Lotan, Yair

AU - Sun, Maxine

AU - Karakiewicz, Pierre I.

AU - Abdennabi, Joual

AU - Fajkovic, Harun

AU - Loidl, Wolfgang

AU - Chun, Felix K.

AU - Fisch, Margit

AU - Scherr, Douglas S.

AU - Shariat, Shahrokh F.

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N2 - Purpose: We investigated the effects of cigarette smoking status, cumulative exposure and time from cessation on disease recurrence and progression in patients with a history of recurrent nonmuscle invasive bladder cancer. Materials and Methods: A total of 390 patients with recurrent nonmuscle invasive bladder cancer were treated with transurethral resection of the bladder, of whom 159 (41%) received instillation therapy immediately postoperatively and 73 (19%) received adjuvant intravesical immunotherapy or chemotherapy. Smoking history included smoking status, number of cigarettes per day, smoking duration in years and years since smoking cessation. Cumulative smoking exposure was categorized as light short-term - 19 or fewer cigarettes per day and 19.9 years or less, moderate - all combinations except light short-term and heavy long-term, and heavy long-term - 20 or greater cigarettes per day and 20 years or greater. Results: A total of 91 (23%), 192 (49%) and 107 patients (28%) were never, former and current smokers, respectively. Of ever smokers 56 (19%), 156 (52%) and 87 (29%) were light short-term, moderate and heavy long-term smokers, respectively. There was no difference in the risk of disease recurrence and progression among current, former and never smokers. On univariable analyses in ever smokers the risk of disease recurrence and progression increased with augmented smoking intensity (p ≤0.015), duration (p <0.001) and cumulative exposure (p <0.001). On multivariable analyses cumulative smoking exposure was an independent risk factor for disease recurrence and progression (p ≤0.003). Smoking cessation greater than 10 years before treatment was independently associated with decreased disease recurrence compared to current smoking (HR 0.4, p <0.001). In addition, current smokers had worse survival than former smokers, who in turn had worse survival than never smokers (p >0.05). Conclusions: There is a dose-response relationship of smoking exposure and smoking cessation with disease recurrence and progression in ever smokers with a history of recurrent nonmuscle invasive bladder cancer. These findings support counseling on smoking cessation benefits.

AB - Purpose: We investigated the effects of cigarette smoking status, cumulative exposure and time from cessation on disease recurrence and progression in patients with a history of recurrent nonmuscle invasive bladder cancer. Materials and Methods: A total of 390 patients with recurrent nonmuscle invasive bladder cancer were treated with transurethral resection of the bladder, of whom 159 (41%) received instillation therapy immediately postoperatively and 73 (19%) received adjuvant intravesical immunotherapy or chemotherapy. Smoking history included smoking status, number of cigarettes per day, smoking duration in years and years since smoking cessation. Cumulative smoking exposure was categorized as light short-term - 19 or fewer cigarettes per day and 19.9 years or less, moderate - all combinations except light short-term and heavy long-term, and heavy long-term - 20 or greater cigarettes per day and 20 years or greater. Results: A total of 91 (23%), 192 (49%) and 107 patients (28%) were never, former and current smokers, respectively. Of ever smokers 56 (19%), 156 (52%) and 87 (29%) were light short-term, moderate and heavy long-term smokers, respectively. There was no difference in the risk of disease recurrence and progression among current, former and never smokers. On univariable analyses in ever smokers the risk of disease recurrence and progression increased with augmented smoking intensity (p ≤0.015), duration (p <0.001) and cumulative exposure (p <0.001). On multivariable analyses cumulative smoking exposure was an independent risk factor for disease recurrence and progression (p ≤0.003). Smoking cessation greater than 10 years before treatment was independently associated with decreased disease recurrence compared to current smoking (HR 0.4, p <0.001). In addition, current smokers had worse survival than former smokers, who in turn had worse survival than never smokers (p >0.05). Conclusions: There is a dose-response relationship of smoking exposure and smoking cessation with disease recurrence and progression in ever smokers with a history of recurrent nonmuscle invasive bladder cancer. These findings support counseling on smoking cessation benefits.

KW - carcinoma

KW - smoking

KW - survival

KW - urinary bladder

KW - urothelium

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