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. 2022 Jun;207(6):1200-1206.
doi: 10.1097/JU.0000000000002449. Epub 2022 Jan 27.

Association of Biochemically Verified Post-Diagnosis Smoking and Nonmuscle-Invasive Bladder Cancer Recurrence Risk

Helena Furberg  1 , Stacey Petruzella  1 , Karissa Whiting  1 , Emily Stein  1 , Irene Orlow  1 , Jessica Kenney  1 , Sergio Corrales-Guerrero  1 , Nicole Benfante  1 , Eugene K Cha  1 , Timothy F Donahue  1 , Sherri M Donat  1 , Harry W Herr  1 , Richard S Matulewicz  1 , Eugene Pietzak  1 , Guido Dalbagni  1 , Jamie Ostroff  1 , Bernard H Bochner  1
Affiliations

Association of Biochemically Verified Post-Diagnosis Smoking and Nonmuscle-Invasive Bladder Cancer Recurrence Risk

Helena Furberg et al. J Urol. 2022 Jun.

Abstract

Purpose: Our goal was to determine the association between biochemically verified post-diagnosis smoking exposure and nonmuscle-invasive bladder cancer (NMIBC) recurrence risk.

Materials and methods: We conducted a prospective study of 354 NMIBC patients with a smoking history undergoing care between 2015 and 2018. Patients contributed at least 2 biospecimens during followup which were tested for cotinine to determine biochemically verified post-diagnosis smoking exposure (yes/no). Our primary endpoint was time to first recurrence after study start date. We examined whether post-diagnosis smoking exposure was associated with recurrence risk in multivariable Cox proportional hazards models that accounted for demographics, clinicopathological variables, time since diagnosis and pack-years.

Results: Patients were predominantly White, male and had a median age of 68 years. Most patients had Ta disease (62%) and tumors of high grade (68%). Intravesical bacillus Calmette-Guérin was given to 63% of the cohort. Patients were followed for a median of 3.6 years since study start. Post-diagnosis smoking exposure was detected in 22% of patients, and 38.7% (137) of patients experienced a recurrence during followup. In multivariable models, only bacillus Calmette-Guérin treatment and prior recurrence rate were significantly associated with recurrence. There was no association between post-diagnosis smoking exposure and recurrence risk (HR: 0.73, 95% CI: 0.45-1.20).

Conclusions: In a cohort of patients with predominantly high risk NMIBC, post-diagnosis smoking exposure was not associated with NMIBC recurrence. However, smoking cessation support remains a critical component of cancer care given that the benefits of quitting extend far beyond NMIBC recurrence.

Keywords: cotinine; smoking; urinary bladder neoplasms.

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Figures

Figure 1.
Figure 1.
Cumulative incidence of disease recurrence curve among 354 recently diagnosed NMIBC patients.
See this image and copyright information in PMC

Comment in

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