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. 2017 Jan;49(1):69-76.
doi: 10.1007/s11255-016-1441-6. Epub 2016 Oct 20.

Impact of smoking status and cumulative smoking exposure on tumor recurrence of non-muscle-invasive bladder cancer

Hao Min Li  1 , Baihetiya Azhati  1 , Mulati Rexiati  1 , Wen Guang Wang  1 , Xiao Dong Li  1 , Qiang Liu  1 , Yu-Jie Wang  2
Affiliations

Impact of smoking status and cumulative smoking exposure on tumor recurrence of non-muscle-invasive bladder cancer

Hao Min Li et al. Int Urol Nephrol. 2017 Jan.

Abstract

Objective: To investigate the effect of smoking status, cumulative smoking exposure and smoking cessation on the outcomes of patient with non-muscle-invasive bladder cancer (NMIBC).

Methods: We collected smoking data from 484 patients with NMIBC who were treated with transurethral resection (TUR); smoking status was categorized as (never smokers vs current smokers vs former smokers). Cumulative smoking exposure was categorized as high smoking exposure (cigarette index ≥400) versus low smoking exposure (cigarette index <400). Association with outcomes was examined by multivariable analyses after adjusting for the effects of standard clinicopathologic factors, and the Kaplan-Meier method was used to estimate the effect of smoking status and cumulative smoking exposure on RFS.

Results: A total of 168 (34.7 %) patients were never smoker, 121 (25 %) patients were current smokers, and 195 (40.3 %) patients were former smokers. The median follow-up was 25 months. By multivariate analysis, pathological grade (p = 0.013), history of recurrence (p < 0.001), number of tumors (p < 0.001) and size of tumors (p = 0.013) were significantly associated with tumor recurrence; nevertheless, smoking status did not influence tumor recurrence (p = 0.063). Among current and former smokers, cumulative smoking exposure was significantly associated with tumor recurrence (p < 0.001), compared to current smokers, patients with smoking cessation ≥10 years had a lower risk of tumor recurrence [hazard ratio (HR) 0.456, p = 0.007].

Conclusions: Smoking affects the prognosis of patient with NMIBC, which is still controversial; however, among ever smokers, a high cumulative exposure smoking can significantly increase the risk of tumor recurrence. Quitting smoking might be associated with a lower recurrence rate for patients with NMIBC.

Keywords: Cumulative exposure smoking; Non-muscle-invasive bladder cancer; Recurrence; Smoking status; Survival.

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