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.
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.
Authors: Anne J Grotenhuis; Cornelis W Ebben; Katja K Aben; J Alfred Witjes; Alina Vrieling; Sita H Vermeulen; Lambertus A Kiemeney Journal: Urol Oncol Date: 2014-07-09 Impact factor: 3.498
Authors: Richard S Matulewicz; Ramsankar Basak; Ibardo Zambrano; Bianca A Dearing; Daniel Schatz; Omar El Shahawy; Scott Sherman; Marc A Bjurlin Journal: J Urol Date: 2020-12-21 Impact factor: 7.450
Authors: Rianne J M Lammers; Wim P J Witjes; Kees Hendricksen; Christien T M Caris; Maria H C Janzing-Pastors; J Alfred Witjes Journal: Eur Urol Date: 2011-07-14 Impact factor: 20.096
Authors: Richard J Sylvester; Adrian P M van der Meijden; Willem Oosterlinck; J Alfred Witjes; Christian Bouffioux; Louis Denis; Donald W W Newling; Karlheinz Kurth Journal: Eur Urol Date: 2006-01-17 Impact factor: 20.096
Authors: Marc A Bjurlin; Matthew R Cohn; Dae Y Kim; Vincent L Freeman; Lindsay Lombardo; Stephen D Hurley; Courtney M P Hollowell Journal: J Urol Date: 2012-11-15 Impact factor: 7.450
Authors: Sam S Chang; Stephen A Boorjian; Roger Chou; Peter E Clark; Siamak Daneshmand; Badrinath R Konety; Raj Pruthi; Diane Z Quale; Chad R Ritch; John D Seigne; Eila Curlee Skinner; Norm D Smith; James M McKiernan Journal: J Urol Date: 2016-06-16 Impact factor: 7.450
Authors: Richard S Matulewicz; Kourosh Ravvaz; John A Weissert; Sima Porten; Gary D Steinberg Journal: Urol Oncol Date: 2021-05-28 Impact factor: 3.498