Does Smoking Cessation at Primary Diagnosis Reduce the Recurrence Risk of Nonmuscle-Invasive Bladder Cancer? Results of a Prospective Study
| Autor: | Carlo Pavone, Loris Cacciatore, Davide Baiamonte, Fabrizio Di Maida, Cristina Scalici Gesolfo, Maria Rosaria Valerio, Vincenzo Serretta, Marco Vella, Chiara Sanfilippo |
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| Přispěvatelé: | Serretta, Vincenzo, Di Maida, Fabrizio, Baiamonte, Davide, Vella, Marco, Pavone, Carlo, Cacciatore, Lori, Valerio, Maria Rosaria, Scalici Gesolfo, Cristina, Sanfilippo, Chiara |
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis Urology medicine.medical_treatment Disease-Free Survival Recurrence risk Cigarette smoking Recurrence Internal medicine medicine Nonmuscle-invasive bladder cancer Humans Statistical analysis Neoplasm Invasiveness Prospective Studies Prospective cohort study Pathological Aged Bladder cancer business.industry Middle Aged medicine.disease Primary tumor Urinary Bladder Neoplasms Smoking cessation Smoking Cessation Neoplasm Recurrence Local business |
| Zdroj: | Urologia internationalis. 104(5-6) |
| ISSN: | 1423-0399 |
| Popis: | Introduction: Evidence that smoking cessation at first diagnosis of nonmuscle-invasive bladder cancer (NMIBC) reduces the risk of recurrence is lacking. The aim of our prospective study was to analyze the association between patients’ changes in smoking habits after diagnosis and recurrence-free survival (RFS). Patients: After transurethral resection of primary NMIBC, patients were classified as “ex-smokers,” i.e., those definitively stopping, and as “active smokers,” i.e., those continuing or restarting to smoke. Smoking status was reassessed every 3 months during the first year and every 6 months thereafter. Data on patients’ demographics, smoking status, tumor characteristics, treatments, and follow-up were collected. Statistical analysis was performed adopting SPSS 15.0.1 and R3.4.2 software. Results: Out of 194 patients, 67 (34.5%) quit smoking after the diagnosis, while 127 (65.5%) did not. The clinical and pathological characteristics were homogeneously distributed. At a median follow-up of 38 months, 106 patients (54.6%) recurred, 33 (49.2%) ex- and 73 (60.3%) active smokers with a 3-year RFS of 42.3 and 50.7%, respectively (p = 0.55). No statistically significant association between recurrence, pathological features of the primary tumor, and patient smoking habits after diagnosis was detected. Results were not statistically influenced by the intensity (cigarette/day) and duration (years) of smoking. In multivariate analysis, cigarette smoking cessation at diagnosis did not significantly reduce tumor recurrence. Conclusion: In our prospective study, more than half of our patients recurred at 3 years. In multivariate analysis, smoking cessation did not significantly reduce tumor recurrence. However, the 8.4% reduction in favor of the ex-smokers suggests the need of larger studies with longer follow-ups. Surprisingly, only 35% of smokers definitively quit after diagnosis. The urologists should play a more active role to persuade the patients to stop smoking at first cancer diagnosis. |
| Databáze: | OpenAIRE |
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