Determine the association between biochemically verified post-diagnosis smoking exposure and non-muscle invasive bladder cancer (NMIBC) recurrence risk.
We conducted a prospective study of 354 NMIBC patients with a smoking history undergoing care between 2015 and 2018. Patients contributed at least two biospecimens during follow-up 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.
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 BCG 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. 38.7% (n=137) of patients experienced a recurrence during follow up. In multivariable models, only BCG treatment and prior recurrence rate were significantly associated with recurrence. There was no association between post-diagnosis smoking exposure and recurrence risk (Hazard Ratio (HR): 0.73 (95% Confidence Interval (CI): 0.45-1.20)).
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.
The Journal of urology. 2022 Jan 27 [Epub ahead of print]
Helena Furberg, Stacey Petruzella, Karissa Whiting, Emily Stein, Irene Orlow, Jessica Kenney, Sergio Corrales-Guerrero, Nicole Benfante, Eugene K Cha, Timothy F Donahue, Sherri M Donat, Harry W Herr, Richard S Matulewicz, Eugene Pietzak, Guido Dalbagni, Jamie Ostroff, Bernard H Bochner
Memorial Sloan Kettering Cancer Center, New York City, New York.