Danilo Leite Andrade1, Tomas Bernardo Costa Moretti1, Wilmar Azal Neto1, Júlia Benedetti1, Leonardo Oliveira Reis2. 1. Department of Urology, UroScience, State University of Campinas, Unicamp and Pontifical Catholic University of Campinas, PUC-Campinas, Av. John Boyd Dunlop-Jardim Ipaussurama, Campinas, SP, CEP: 13034-685, Brazil. 2. Department of Urology, UroScience, State University of Campinas, Unicamp and Pontifical Catholic University of Campinas, PUC-Campinas, Av. John Boyd Dunlop-Jardim Ipaussurama, Campinas, SP, CEP: 13034-685, Brazil. reisleo.l@gmail.com.
Abstract
PURPOSE: Smoking habit is the major risk factor for bladder cancer (BC), related to about 50% of these tumors; however, the tobacco dose-effect impact on BC immune treatment is underexplored. This study evaluates the impact of smoke load on non-muscle invasive bladder cancer (NMIBC) prognosis after intravesical BCG. METHODS: Smoke load, recurrence, progression and disease-specific survival were evaluated in a retrospective study including NMIBC patients treated with intravesical BCG between 2006 and 2015. Multivariate Cox regression, ROC and Kaplan-Meier curves were utilized. RESULTS: 132 pT1 NMIBC patients were included: 95 (72%) males, mean age 69.6 ± 10.5 years and mean smoking pack-years 22.0 ± 20.8. Recurrence, progression and disease-specific death occurred in 69 (52.3%, mean 20.55 ± 20.44 months), 22 (16.7%, mean 31.39 ± 20.19 months) and 11 (8.3%, mean 37.23 ± 18.34 months), respectively. Smoke load significantly impacted recurrence, HR = 1.019 (95% CI 1.008-1.030, p = 0.0004), and progression, HR = 1.034 (95% CI 1.016-1.052, p = 0.0002), but not survival. For every 1-year increment in pack-years, the risk of relapse and progression increases by 1.9% and 3.4%, respectively. Over 20 pack-year showed the best predictive prognostic power. CONCLUSION: The smoke load has a potential prognostic role in terms of recurrence and progression in the BCG treated NMIBC. Future studies should explore the smoking impact on the immune system, mainly beyond 20 pack-year.
PURPOSE: Smoking habit is the major risk factor for bladder cancer (BC), related to about 50% of these tumors; however, the tobacco dose-effect impact on BC immune treatment is underexplored. This study evaluates the impact of smoke load on non-muscle invasive bladder cancer (NMIBC) prognosis after intravesical BCG. METHODS: Smoke load, recurrence, progression and disease-specific survival were evaluated in a retrospective study including NMIBC patients treated with intravesical BCG between 2006 and 2015. Multivariate Cox regression, ROC and Kaplan-Meier curves were utilized. RESULTS: 132 pT1 NMIBC patients were included: 95 (72%) males, mean age 69.6 ± 10.5 years and mean smoking pack-years 22.0 ± 20.8. Recurrence, progression and disease-specific death occurred in 69 (52.3%, mean 20.55 ± 20.44 months), 22 (16.7%, mean 31.39 ± 20.19 months) and 11 (8.3%, mean 37.23 ± 18.34 months), respectively. Smoke load significantly impacted recurrence, HR = 1.019 (95% CI 1.008-1.030, p = 0.0004), and progression, HR = 1.034 (95% CI 1.016-1.052, p = 0.0002), but not survival. For every 1-year increment in pack-years, the risk of relapse and progression increases by 1.9% and 3.4%, respectively. Over 20 pack-year showed the best predictive prognostic power. CONCLUSION: The smoke load has a potential prognostic role in terms of recurrence and progression in the BCG treated NMIBC. Future studies should explore the smoking impact on the immune system, mainly beyond 20 pack-year.
Authors: Jeremy Yuen-Chun Teoh; Ashish M Kamat; Peter C Black; Petros Grivas; Shahrokh F Shariat; Marek Babjuk Journal: Nat Rev Urol Date: 2022-03-31 Impact factor: 16.430
Authors: Leonardo Oliveira Reis; Luciana S B Dal Col; Diego M Capibaribe; Gustavo B de Mendonça; Fernandes Denardi; Athanase Billis Journal: Investig Clin Urol Date: 2022-01
Authors: Matteo Ferro; Octavian Sabin Tătaru; Gennaro Musi; Giuseppe Lucarelli; Abdal Rahman Abu Farhan; Francesco Cantiello; Rocco Damiano; Rodolfo Hurle; Roberto Contieri; Gian Maria Busetto; Giuseppe Carrieri; Luigi Cormio; Francesco Del Giudice; Alessandro Sciarra; Sisto Perdonà; Marco Borghesi; Carlo Terrone; Evelina La Civita; Pierluigi Bove; Riccardo Autorino; Matteo Muto; Nicolae Crisan; Michele Marchioni; Luigi Schips; Francesco Soria; Daniela Terracciano; Rocco Papalia; Felice Crocetto; Biagio Barone; Giorgio Ivan Russo; Stefano Luzzago; Giuseppe Mario Ludovico; Mihai Dorin Vartolomei; Francesco Alessandro Mistretta; Vincenzo Mirone; Ottavio de Cobelli Journal: Diagnostics (Basel) Date: 2022-02-25