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

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).

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.

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].

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.

International urology and nephrology. 2016 Oct 20 [Epub ahead of print]

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

Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Medical University, Xinjiang, 830054, People's Republic of China., Department of Urology, The First Affiliated Hospital of Xinjiang Medical University, Xinjiang Medical University, Xinjiang, 830054, People's Republic of China. .