The impact of smoking on pathologic response to neoadjuvant cisplatin-based chemotherapy in patients with muscle-invasive bladder cancer Journal Article


Authors: Kim, P. H.; Kent, M.; Zhao, P.; Sfakianos, J. P.; Bajorin, D. F.; Bochner, B. H.; Dalbagni, G.
Article Title: The impact of smoking on pathologic response to neoadjuvant cisplatin-based chemotherapy in patients with muscle-invasive bladder cancer
Abstract: Purpose: Smoking is the primary etiologic risk factor for bladder cancer and has been implicated in mechanisms of chemoresistance. We investigated smoking as a potential predictor for pathologic outcomes after neoadjuvant chemotherapy (NC) and radical cystectomy (RC) for muscle-invasive bladder cancer. Methods: We identified 139 patients treated with neoadjuvant cisplatin-based chemotherapy followed by RC for T2-4aN0M0 bladder cancer. Logistic regression was used to evaluate associations between smoking characteristics and pathologic outcomes (pT0, complete response; pT0/pTis/pT1, any response). In a secondary analysis, multivariate Cox regression was used to assess associations between smoking and recurrence-free and cancer-specific survival. Results: Our cohort consisted of 99 (71 %) males, with a median age of 65 (interquartile range 56, 71). Prevalence of never, former, and current smokers was 25, 45, and 29 %, respectively. In total, 63 patients experienced disease recurrence, 39 died of disease, and 11 died of other causes. There were no statistically significant associations between smoking characteristics and complete (p = 0.5) or any (p = 0.2) pathologic response to NC. Similarly, we did not find any association between smoking characteristics and recurrence (p = 0.6) or cancer-specific survival (p = 0.9). Conclusions: In this series, smoking characteristics were not found to be predictive of pathologic response after NC and RC, although this analysis was limited by the small study sample size. However, the harmful effects of smoking warrants continued emphasis on smoking cessation counseling in bladder cancer patients. © 2013 Springer-Verlag Berlin Heidelberg.
Keywords: cisplatin; smoking; bladder cancer; radical cystectomy; neoadjuvant chemotherapy
Journal Title: World Journal of Urology
Volume: 32
Issue: 2
ISSN: 0724-4983
Publisher: Springer  
Date Published: 2014-04-01
Start Page: 453
End Page: 459
Language: English
DOI: 10.1007/s00345-013-1128-x
PROVIDER: scopus
PMCID: PMC3905053
PUBMED: 23842986
DOI/URL:
Notes: Export Date: 1 May 2014 -- Source: Scopus
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MSK Authors
  1. Dean Bajorin
    416 Bajorin
  2. Guido Dalbagni
    253 Dalbagni
  3. Bernard Bochner
    327 Bochner
  4. Philip Hyunwoo Kim
    39 Kim
  5. Philip Tong Zhao
    1 Zhao
  6. Matthew T Kent
    26 Kent