MP24-08 SMOKING EXPOSURE MIGHT CORRELATE WITH POOR NEOADJUVANT CHEMOTHERAPY RESPONSE AND SURVIVAL OUTCOMES FOLLOWING RADICAL CYSTECTOMY: SYSTEMATIC REVIEW AND PROGNOSTIC META-ANALYSIS

Abstract

You have accessJournal of UrologyBladder Cancer: Epidemiology & Evaluation I (MP24)1 Apr 2020MP24-08 SMOKING EXPOSURE MIGHT CORRELATE WITH POOR NEOADJUVANT CHEMOTHERAPY RESPONSE AND SURVIVAL OUTCOMES FOLLOWING RADICAL CYSTECTOMY: SYSTEMATIC REVIEW AND PROGNOSTIC META-ANALYSIS Giovanni Cacciamani*, Saum Ghodoussipour, Karanvir Gill, Mihir Desai, Walter Artibani, Atsuko Iwata, Tsuyosh Iwata, Parkash Gill, Shahrokh Shariat, Andre Abreu, Inderbir Gill, and Djaladat Hooman Giovanni Cacciamani*Giovanni Cacciamani* More articles by this author , Saum GhodoussipourSaum Ghodoussipour More articles by this author , Karanvir GillKaranvir Gill More articles by this author , Mihir DesaiMihir Desai More articles by this author , Walter ArtibaniWalter Artibani More articles by this author , Atsuko IwataAtsuko Iwata More articles by this author , Tsuyosh IwataTsuyosh Iwata More articles by this author , Parkash GillParkash Gill More articles by this author , Shahrokh ShariatShahrokh Shariat More articles by this author , Andre AbreuAndre Abreu More articles by this author , Inderbir GillInderbir Gill More articles by this author , and Djaladat HoomanDjaladat Hooman More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000857.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Preoperative tobacco smoking is a known risk factor for complications after major abdominal surgery and has been suggested as a risk factor for poorer long-term oncologic outcomes after cancer surgeryTo investigate the impact of tobacco smoking exposure, duration, intensity, and cessation on response to neoadjuvant chemotherapy (NACh) and long-term survival outcomes in patients undergoing radical cystectomy (RC) for bladder cancer (BCa). METHODS: A systematic search of original articles published up to April 2019 was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement and Methods and Guide for effectiveness and comparative Effectiveness Review of the Agency for Healthcare Research and Quality (AHRQ). PubMed, MEDLINE, Embase, and Cochrane Library and clinicaltrials.gov databases were screened for observational studies reporting Cox proportional hazards regression or logistic regression analyses. Outcomes of interest were overall mortality (OM), cancer-specific mortality (CSM) and bladder cancer Recurrence (BCaR). Available multivariable hazard ratios (HRs) and their 95% CIs were included in quantitative analysis. Sensitivity analyses were performed as appropriate. RESULTS: Our electronic search identified a total of 649 papers. After a detailed review, we selected 17 studies reporting the impact of smoking status on survival outcomes of 13,777 patients underwent RC. The pooled meta-analysis revealed that active smokers have an increased risk of experiencing mortality for any cause (HR: 1.21; 95%CI: 1.08, 1.36; p=0.001, I2=0%), CSM (HR: 1.24; 95%CI: 1.13, 1.36; p<0.00001, I2=0%) and BCaR (HR: 1.24; 95%CI: 1.12, 1.38; p<0.0001, I2=3%). The sensitivity analysis evaluating only patients underwent NACH followed by RC showed an advantage of no/never smokers in term of NACh complete response rate (HR: 0.47; 95%CI: 0.29, 0.75; p=0.001, I2=0%). CONCLUSIONS: The results of the present meta-analysis revealed that smoking exposure is associated with worse response to NACh and oncologic outcomes following RC for BCa. Active smokers had higher OM, CSM, NACh response, and greater BCaR compared to non-smokers, but the differences were less significant in former smokers vs. never smokers. Source of Funding: None © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue Supplement 4April 2020Page: e350-e350 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Giovanni Cacciamani* More articles by this author Saum Ghodoussipour More articles by this author Karanvir Gill More articles by this author Mihir Desai More articles by this author Walter Artibani More articles by this author Atsuko Iwata More articles by this author Tsuyosh Iwata More articles by this author Parkash Gill More articles by this author Shahrokh Shariat More articles by this author Andre Abreu More articles by this author Inderbir Gill More articles by this author Djaladat Hooman More articles by this author Expand All Advertisement PDF downloadLoading ...