NEW ORLEANS, LA USA (UroToday.com) - Refraining from smoking for 15 years or more decreased the risk of tumor recurrence in patients with non-muscle invasive bladder cancer (NMIBT), regardless of the intensity or duration of history of smoking, according to results from a Japanese study reported at the May 2015 American Urological Association Annual Meeting.
For their investigation, Dr. Koichiro Ogihara and colleagues identified 408 NMIBT cases (326 men and 82 women) with a mean age 67.9 years. All patients had undergone transurethral resection of the bladder tumor (TURBT) between April 1995 and April 2013. Detailed smoking histories were available for all.
Patients were divided into 3 groups by smoking status: non-smokers, ex-smokers, and current smokers. The median follow-up was 5.77 years, and the primary outcome measure was recurrence-free survival (RFS).
Five-year RFS rates for the ex-smoker group (45.3±5.1%) and current smoker group (43.0±5.0%, p < 0.001 each) were significantly lower than for those in the non-smoker group (73.3±3.6%). Smoking status was an independent indicator for RFS in addition to multiple tumors and the absence of BCG intravesical therapy.
When the investigators further divided the ex-smoker group into 2 groups--those who had not smoked for at least 15 years and those who quit smoking less than 15 years ago at the time of TURBT, they found that the 5-year RFS rate for the short-term abstinence group was significantly lower than that of the long-term abstinence group. In multivariate analyses, multiple tumors, pathological stage T1 tumor, and quitting smoking within 15 years were independent predictors for tumor recurrence. (Smoking duration and pack-years were not evaluated.)
The current study addresses an issue that has not been fully enlightened even after countless investigations into the health effects of smoking, namely, details of the association between smoking status and tumor recurrence, or if smoking cessation can reduce the chance of tumor recurrence,” the researchers stated in their report.
Results from this study thus provide encouragement for smokers and ex-smokers that stopping smoking over the long term can indeed reduce health impacts.
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PD17-08: Refraining from smoking for 15 years or more reduced the risk of tumor recurrence in non-muscle invasive bladder cancer patients
Koichiro Ogihara*, Eiji Kikuchi, Kazuyuki Yuge, Nobuyuki Tanaka, Kazuhiro Matsumoto, Akira Miyajima, Mototsugu Oya, Tokyo, Japan
Introduction and Objectives
Smoking is one of the established carcinogenic risk factors of bladder cancer. However, in clinical epidemiologic and basic studies, little is known about the details of the association between smoking status and tumor recurrence, or if smoking cessation can reduce the chance of tumor recurrence. The aim of the present study was to evaluate whether smoking status and smoking cessation affect tumor recurrence in patients with non-muscle invasive bladder cancer (NMIBC).
Methods
We identified 408 cases (Male: 326, Female: 82) treated by TURBT for NMIBC between April 1995 and April 2013 at our institution and for whom detailed information concerning smoking was available. We investigated the association between smoking status and tumor recurrence. The patients were divided into 3 groups according to their smoking status; non-smokers, ex-smokers, and current smokers. The mean age was 67.9 years and the median follow-up period was 5.77 years. The primary outcome measure was recurrence-free survival (RFS).
Results
The non-smoker, ex-smoker, and current smoker groups consisted of 178 cases (43.6%), 113 cases (27.7%), and 117 cases (28.7%), respectively. The 5-year RFS rates for the ex-smoker group (45.3±5.1%) and current smoker group (43.0±5.0%, p < 0.001 each) were significantly lower than that of the non-smoker group (73.3±3.6%). Multivariate analysis revealed that smoking status was an independent indicator for RFS in addition to multiple tumors, the absence of BCG intravesical therapy. The ex-smoker group was further divided into 2 groups: those who had not smoked for at least 15 years (long-term abstinence group, N=46) and those who quit smoking less than 15 years ago (short-term abstinence group, N=67) at the time of TURBT. In the ex-smoker group, 13 (11.5%) and 49 (43.4%) had a history of 20 pack-years or more, and 13 (11.5%) and 47 (41.6%) had smoked more than 30 years in the long-term and short-term abstinence groups, respectively. The 5-year RFS rate for the short-term abstinence group (62.2±7.8%) was significantly lower than that of the long-term abstinence group (35.0±6.3%, p=0.010). In multivariate analyses, multiple tumors (HR=1.99, p=0.024), pathological stage T1 tumor (HR=2.21, p=0.016) and quitting smoking within 15 years (HR=2.08, p=0.024) were independent predictors for tumor recurrence. Smoking duration and pack-years were not selected.
Conclusions
Our results suggests that refraining from smoking for 15 years or more decreased the risk of tumor recurrence in NMIBT regardless of the intensity or duration of history of smoking.
Date & Time: May 16, 2015 3:30 PM-5:30 PM
Session Title: Bladder Cancer: Non-invasive II
Sources of Funding: none
Presented by Koichiro Ogihara at the American Urological Association (AUA) Annual Meeting - May 15 - 19, 2015 - New Orleans, LA USA
Tokyo, Japan