897 IMPACT OF SMOKING STATUS ON BLADDER RECURRENCE FOLLOWING RADICAL NEPHROURETERECTOMY IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA

Abstract

You have accessJournal of UrologyUrothelial Cancer: Upper Tract Tumors (II)1 Apr 2013897 IMPACT OF SMOKING STATUS ON BLADDER RECURRENCE FOLLOWING RADICAL NEPHROURETERECTOMY IN PATIENTS WITH UPPER TRACT UROTHELIAL CARCINOMA Masayuki Hagiwara, Eiji Kikuchi, Nobuyuki Tanaka, Kazuhiro Matsumoto, Hiroki Ide, Akira Miyajima, Ken Nakagawa, Takeshi Masuda, So Nakamura, and Mototsugu Oya Masayuki HagiwaraMasayuki Hagiwara Tokyo, Japan More articles by this author , Eiji KikuchiEiji Kikuchi Tokyo, Japan More articles by this author , Nobuyuki TanakaNobuyuki Tanaka Tokyo, Japan More articles by this author , Kazuhiro MatsumotoKazuhiro Matsumoto Tokyo, Japan More articles by this author , Hiroki IdeHiroki Ide Tokyo, Japan More articles by this author , Akira MiyajimaAkira Miyajima Tokyo, Japan More articles by this author , Ken NakagawaKen Nakagawa Tokyo, Japan More articles by this author , Takeshi MasudaTakeshi Masuda Saitama, Japan More articles by this author , So NakamuraSo Nakamura Tokyo, Japan More articles by this author , and Mototsugu OyaMototsugu Oya Tokyo, Japan More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2013.02.470AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Although smoking status has a significant impact on outcome in patients with bladder cancer, its role in the outcome of upper tract urothelial cancer (UTUC) has not yet been fully evaluated. The aims of the present study were to identify independent risk factors of subsequent bladder recurrence in a large series of patients with UTUC and to investigate the possible influence of smoking status on subsequent bladder recurrence after surgery. METHODS We identified a study population of 313 consecutive patients treated with nephroureterectomy for UTUC at our 3 institutions between 1994 and 2010.ü@The associations between the subsequent bladder recurrence and the clinicopathological parameters, including smoking status, were analyzed. RESULTS There were 97 (31.0%) current smokers, 63 (20.1%) ex-smokers, and 153 (48.9%) non-smokers. While we combined ex-smokers and current smokers and classified them as having a positive history of smoking, this group had a significantly higher incidence of high grade tumors compared with non-smokers (P=0.018). During follow-up, bladder recurrence developed in 156 patients (49.8%); 63 current smokers, 34 ex-smokers, 59 non-smokers.ü@The 3-year bladder recurrence-free survival (BRFS) rates were 32.5% in the positive smoking group and 59.9% in non-smokers (P<0.001). Multivariate analysis showed that male gender (P=0.010, HR=1.83) and a positive smoking history (P=0.028, HR=1.50) were independent risk factors for subsequent bladder recurrence. In a subgroup of patients with a positive history of smoking, the 3-year BRFS rate in patient with ≥50 pack-years (14.0%) and those who smoked ≥40 cigarettes per day (6.4%) were significantly lower compared to their counterparts (35.6% and 33.3%, respectively). Multivariate analysis revealed that the number of pack-years ≥50 (P=0.019, HR=1.63) and number of cigarettes per day ≥40 (P=0.011, HR=1.82) were independent risk factors for bladder recurrence in patients with a positive smoking history. CONCLUSIONS A history of smoking and male gender were independent risk factors for subsequent bladder recurrence following nephroureterectomy, and UTUC patients who smoked a large number of cigarettes or long history of smoking had a higher incidence of bladder recurrence. More attention should be paid to the association between smoking status and a worse oncological outcome, such as bladder recurrence, in UTUC patients. © 2013 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 189Issue 4SApril 2013Page: e370-e371 Advertisement Copyright & Permissions© 2013 by American Urological Association Education and Research, Inc.MetricsAuthor Information Masayuki Hagiwara Tokyo, Japan More articles by this author Eiji Kikuchi Tokyo, Japan More articles by this author Nobuyuki Tanaka Tokyo, Japan More articles by this author Kazuhiro Matsumoto Tokyo, Japan More articles by this author Hiroki Ide Tokyo, Japan More articles by this author Akira Miyajima Tokyo, Japan More articles by this author Ken Nakagawa Tokyo, Japan More articles by this author Takeshi Masuda Saitama, Japan More articles by this author So Nakamura Tokyo, Japan More articles by this author Mototsugu Oya Tokyo, Japan More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...