Association of smoking history on health-related quality of life in patients undergoing radical cystecomy Journal Article


Authors: Beech, B. B.; Doudt, A. D.; Sjoberg, D. D.; Clements, M. B.; Tin, A. L.; Atkinson, T. M.; Li, Y.; Rapkin, B. D.; Vickers, A. J.; Matulewicz, R. S.; Bochner, B. H.
Article Title: Association of smoking history on health-related quality of life in patients undergoing radical cystecomy
Abstract: Purpose: Radical cystectomy (RC) has the potential to impact health-related quality of life (HRQOL). Many patients who undergo RC are current or former smokers. To better inform preoperative patient counseling, we examined the association between smoking status and HRQOL after RC. Materials and Methods: A secondary analysis was performed on a prospective, longitudinal study (2008–2014) examining HRQOL in patients undergoing RC for bladder cancer. We analyzed 12 validated patient-reported outcome measures that focused on functional, symptomatic, psychosocial, and global HRQOL domains. Measures were collected pre-operatively and 3-, 6-, 12-, 18-, and 24-months postoperatively. For each HRQOL domain, we estimated the mean domain scores using a generalized estimation equation linear regression model. Each model included survey time, smoking status, and time-smoking interaction as covariates. Pairwise comparisons of current, former, and never smokers were estimated from the models. Results: Of the 411 patients available for analysis, 29% (n = 119) never smoked, 59% (n = 244) were former smokers, and 12% (n = 48) were current smokers. Over the follow-up period, never smokers compared to current smokers had better global QOL scores (mean difference = +8.9; 95% CI 1.3–16; p = 0.023) and lower pain levels (mean difference = −10; 95% CI −19 to −0.54; p = 0.036). Compared to current smokers, former smokers had marginal improvements in global QOL (+6.9 points) and pain (−7.5 points) during the follow-up period. Conclusions: Current smokers reported worse HRQOL recovery in the 24-months after RC. These findings can be used to counsel patients who smoke on recovery expectations. © 2022
Keywords: quality of life; smoking; bladder cancer; radical cystectomy; patient-reported
Journal Title: Urologic Oncology: Seminars and Original Investigations
Volume: 41
Issue: 7
ISSN: 1078-1439
Publisher: Elsevier Inc.  
Date Published: 2023-07-01
Start Page: 325.e9
End Page: 325.e14
Language: English
DOI: 10.1016/j.urolonc.2022.12.009
PUBMED: 36631370
PROVIDER: scopus
PMCID: PMC10272017
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF -- Source: Scopus
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MSK Authors
  1. Yuelin Li
    219 Li
  2. Andrew J Vickers
    880 Vickers
  3. Thomas Michael Atkinson
    155 Atkinson
  4. Daniel D. Sjoberg
    234 Sjoberg
  5. Bernard Bochner
    468 Bochner
  6. Amy Lam Ling Tin
    114 Tin
  7. Benjamin Buckler Beech
    8 Beech
  8. Alexander Daniel Doudt
    3 Doudt