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Impact of smoking and smoking cessation on outcomes in bladder cancer patients treated with radical cystectomy.

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Impact of smoking and smoking cessation on outcomes in bladder cancer patients treated with radical cystectomy. / Rink, Michael; Zabor, Emily C; Furberg, Helena; Xylinas, Evanguelos; Ehdaie, Behfar; Novara, Giacomo; Babjuk, Marko; Pycha, Armin; Lotan, Yair; Trinh, Quoc-Dien; Chun, Felix K; Lee, Richard K; Karakiewicz, Pierre I; Fisch, Margit; Robinson, Brian D; Scherr, Douglas S; Shariat, Shahrokh F.

In: EUR UROL, Vol. 64, No. 3, 3, 2013, p. 456-464.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Rink, M, Zabor, EC, Furberg, H, Xylinas, E, Ehdaie, B, Novara, G, Babjuk, M, Pycha, A, Lotan, Y, Trinh, Q-D, Chun, FK, Lee, RK, Karakiewicz, PI, Fisch, M, Robinson, BD, Scherr, DS & Shariat, SF 2013, 'Impact of smoking and smoking cessation on outcomes in bladder cancer patients treated with radical cystectomy.', EUR UROL, vol. 64, no. 3, 3, pp. 456-464. https://doi.org/10.1016/j.eururo.2012.11.039

APA

Rink, M., Zabor, E. C., Furberg, H., Xylinas, E., Ehdaie, B., Novara, G., Babjuk, M., Pycha, A., Lotan, Y., Trinh, Q-D., Chun, F. K., Lee, R. K., Karakiewicz, P. I., Fisch, M., Robinson, B. D., Scherr, D. S., & Shariat, S. F. (2013). Impact of smoking and smoking cessation on outcomes in bladder cancer patients treated with radical cystectomy. EUR UROL, 64(3), 456-464. [3]. https://doi.org/10.1016/j.eururo.2012.11.039

Vancouver

Rink M, Zabor EC, Furberg H, Xylinas E, Ehdaie B, Novara G et al. Impact of smoking and smoking cessation on outcomes in bladder cancer patients treated with radical cystectomy. EUR UROL. 2013;64(3):456-464. 3. https://doi.org/10.1016/j.eururo.2012.11.039

Bibtex

@article{4e1ca0feedfd4e30ad085913dcd793ac,
title = "Impact of smoking and smoking cessation on outcomes in bladder cancer patients treated with radical cystectomy.",
abstract = "BACKGROUND: Cigarette smoking is the best-established risk factor for urothelial carcinoma development.OBJECTIVE: To elucidate the association of pretreatment smoking status, cumulative exposure, and time since smoking cessation on outcomes of patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC).DESIGN, SETTING, AND PARTICIPANTS: We retrospectively collected clinicopathologic and smoking variables, including smoking status, number of cigarettes per day (CPD), duration in years, and time since smoking cessation, for 1506 patients treated with RC for UCB. Lifetime cumulative smoking exposure was categorized as light short-term (≤20 CPD for ≤20 yr), light long-term (≤20 CPD for >20 yr), heavy short-term (>20 CPD for ≤20 yr), and heavy long-term (>20 CPD for >20 yr).INTERVENTION: RC and bilateral lymph node (LN) dissection without neoadjuvant chemotherapy.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Logistic regression and competing risk analyses assessed the association of smoking with disease recurrence, cancer-specific mortality, and overall mortality.RESULTS AND LIMITATIONS: There was no difference in clinicopathologic factors between patients who had never smoked (20%), former smokers (46%), and current smokers (34%). Smoking status was associated with the cumulative incidence of disease recurrence (p=0.004) and cancer-specific mortality (p=0.016) in univariable analyses and with disease recurrence in multivariable analysis (p=0.02); current smokers had the highest cumulative incidences. Among ever smokers, cumulative smoking exposure was associated with advanced tumor stages (p<0.001), LN metastasis (p=0.002), disease recurrence (p<0.001), cancer-specific mortality (p=0.001), and overall mortality (p=0.037) in multivariable analyses that adjusted for standard characteristics; heavy long-term smokers had the worst outcomes, followed by light long-term, heavy short-term, and light short-term smokers. Smoking cessation ≥10 yr mitigated the risk of disease recurrence (hazard ratio [HR]: 0.44; p<0.001), cancer-specific mortality (HR: 0.42; p<0.001), and overall mortality (HR: 0.69; p=0.012) in multivariable analyses. The study is limited by its retrospective nature.CONCLUSIONS: Smoking is associated with worse prognosis after RC for UCB. This association seems to be dose-dependent, and its effects are mitigated by >10 yr smoking cessation. Health care practitioners should counsel smokers regarding the detrimental effects of smoking and the benefits of smoking cessation on UCB etiology and prognosis.",
keywords = "Adult, Aged, Aged, 80 and over, Carcinoma, Cystectomy, Disease-Free Survival, Europe, Female, Humans, Kaplan-Meier Estimate, Logistic Models, Lymph Node Excision, Male, Middle Aged, Multivariate Analysis, Neoplasm Recurrence, Local, Neoplasm Staging, North America, Odds Ratio, Retrospective Studies, Risk Factors, Smoking, Smoking Cessation, Time Factors, Treatment Outcome, Urinary Bladder Neoplasms",
author = "Michael Rink and Zabor, {Emily C} and Helena Furberg and Evanguelos Xylinas and Behfar Ehdaie and Giacomo Novara and Marko Babjuk and Armin Pycha and Yair Lotan and Quoc-Dien Trinh and Chun, {Felix K} and Lee, {Richard K} and Karakiewicz, {Pierre I} and Margit Fisch and Robinson, {Brian D} and Scherr, {Douglas S} and Shariat, {Shahrokh F}",
note = "Copyright {\textcopyright} 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.",
year = "2013",
doi = "10.1016/j.eururo.2012.11.039",
language = "English",
volume = "64",
pages = "456--464",
journal = "EUR UROL",
issn = "0302-2838",
publisher = "Elsevier",
number = "3",

}

RIS

TY - JOUR

T1 - Impact of smoking and smoking cessation on outcomes in bladder cancer patients treated with radical cystectomy.

AU - Rink, Michael

AU - Zabor, Emily C

AU - Furberg, Helena

AU - Xylinas, Evanguelos

AU - Ehdaie, Behfar

AU - Novara, Giacomo

AU - Babjuk, Marko

AU - Pycha, Armin

AU - Lotan, Yair

AU - Trinh, Quoc-Dien

AU - Chun, Felix K

AU - Lee, Richard K

AU - Karakiewicz, Pierre I

AU - Fisch, Margit

AU - Robinson, Brian D

AU - Scherr, Douglas S

AU - Shariat, Shahrokh F

N1 - Copyright © 2012 European Association of Urology. Published by Elsevier B.V. All rights reserved.

PY - 2013

Y1 - 2013

N2 - BACKGROUND: Cigarette smoking is the best-established risk factor for urothelial carcinoma development.OBJECTIVE: To elucidate the association of pretreatment smoking status, cumulative exposure, and time since smoking cessation on outcomes of patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC).DESIGN, SETTING, AND PARTICIPANTS: We retrospectively collected clinicopathologic and smoking variables, including smoking status, number of cigarettes per day (CPD), duration in years, and time since smoking cessation, for 1506 patients treated with RC for UCB. Lifetime cumulative smoking exposure was categorized as light short-term (≤20 CPD for ≤20 yr), light long-term (≤20 CPD for >20 yr), heavy short-term (>20 CPD for ≤20 yr), and heavy long-term (>20 CPD for >20 yr).INTERVENTION: RC and bilateral lymph node (LN) dissection without neoadjuvant chemotherapy.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Logistic regression and competing risk analyses assessed the association of smoking with disease recurrence, cancer-specific mortality, and overall mortality.RESULTS AND LIMITATIONS: There was no difference in clinicopathologic factors between patients who had never smoked (20%), former smokers (46%), and current smokers (34%). Smoking status was associated with the cumulative incidence of disease recurrence (p=0.004) and cancer-specific mortality (p=0.016) in univariable analyses and with disease recurrence in multivariable analysis (p=0.02); current smokers had the highest cumulative incidences. Among ever smokers, cumulative smoking exposure was associated with advanced tumor stages (p<0.001), LN metastasis (p=0.002), disease recurrence (p<0.001), cancer-specific mortality (p=0.001), and overall mortality (p=0.037) in multivariable analyses that adjusted for standard characteristics; heavy long-term smokers had the worst outcomes, followed by light long-term, heavy short-term, and light short-term smokers. Smoking cessation ≥10 yr mitigated the risk of disease recurrence (hazard ratio [HR]: 0.44; p<0.001), cancer-specific mortality (HR: 0.42; p<0.001), and overall mortality (HR: 0.69; p=0.012) in multivariable analyses. The study is limited by its retrospective nature.CONCLUSIONS: Smoking is associated with worse prognosis after RC for UCB. This association seems to be dose-dependent, and its effects are mitigated by >10 yr smoking cessation. Health care practitioners should counsel smokers regarding the detrimental effects of smoking and the benefits of smoking cessation on UCB etiology and prognosis.

AB - BACKGROUND: Cigarette smoking is the best-established risk factor for urothelial carcinoma development.OBJECTIVE: To elucidate the association of pretreatment smoking status, cumulative exposure, and time since smoking cessation on outcomes of patients with urothelial carcinoma of the bladder (UCB) treated with radical cystectomy (RC).DESIGN, SETTING, AND PARTICIPANTS: We retrospectively collected clinicopathologic and smoking variables, including smoking status, number of cigarettes per day (CPD), duration in years, and time since smoking cessation, for 1506 patients treated with RC for UCB. Lifetime cumulative smoking exposure was categorized as light short-term (≤20 CPD for ≤20 yr), light long-term (≤20 CPD for >20 yr), heavy short-term (>20 CPD for ≤20 yr), and heavy long-term (>20 CPD for >20 yr).INTERVENTION: RC and bilateral lymph node (LN) dissection without neoadjuvant chemotherapy.OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Logistic regression and competing risk analyses assessed the association of smoking with disease recurrence, cancer-specific mortality, and overall mortality.RESULTS AND LIMITATIONS: There was no difference in clinicopathologic factors between patients who had never smoked (20%), former smokers (46%), and current smokers (34%). Smoking status was associated with the cumulative incidence of disease recurrence (p=0.004) and cancer-specific mortality (p=0.016) in univariable analyses and with disease recurrence in multivariable analysis (p=0.02); current smokers had the highest cumulative incidences. Among ever smokers, cumulative smoking exposure was associated with advanced tumor stages (p<0.001), LN metastasis (p=0.002), disease recurrence (p<0.001), cancer-specific mortality (p=0.001), and overall mortality (p=0.037) in multivariable analyses that adjusted for standard characteristics; heavy long-term smokers had the worst outcomes, followed by light long-term, heavy short-term, and light short-term smokers. Smoking cessation ≥10 yr mitigated the risk of disease recurrence (hazard ratio [HR]: 0.44; p<0.001), cancer-specific mortality (HR: 0.42; p<0.001), and overall mortality (HR: 0.69; p=0.012) in multivariable analyses. The study is limited by its retrospective nature.CONCLUSIONS: Smoking is associated with worse prognosis after RC for UCB. This association seems to be dose-dependent, and its effects are mitigated by >10 yr smoking cessation. Health care practitioners should counsel smokers regarding the detrimental effects of smoking and the benefits of smoking cessation on UCB etiology and prognosis.

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Carcinoma

KW - Cystectomy

KW - Disease-Free Survival

KW - Europe

KW - Female

KW - Humans

KW - Kaplan-Meier Estimate

KW - Logistic Models

KW - Lymph Node Excision

KW - Male

KW - Middle Aged

KW - Multivariate Analysis

KW - Neoplasm Recurrence, Local

KW - Neoplasm Staging

KW - North America

KW - Odds Ratio

KW - Retrospective Studies

KW - Risk Factors

KW - Smoking

KW - Smoking Cessation

KW - Time Factors

KW - Treatment Outcome

KW - Urinary Bladder Neoplasms

U2 - 10.1016/j.eururo.2012.11.039

DO - 10.1016/j.eururo.2012.11.039

M3 - SCORING: Journal article

C2 - 23206854

VL - 64

SP - 456

EP - 464

JO - EUR UROL

JF - EUR UROL

SN - 0302-2838

IS - 3

M1 - 3

ER -