Influence of smoking status on the disease-related outcomes of patients with tobacco-associated superficial transitional cell carcinoma of the bladder Journal Article

  

Authors:	Fleshner, N.; Garland, J.; Moadel, A.; Herr, H.; Ostroff, J.; Trambert, R.; O'Sullivan, M.; Russo, P.
Article Title:	Influence of smoking status on the disease-related outcomes of patients with tobacco-associated superficial transitional cell carcinoma of the bladder
Abstract:	BACKGROUND. The aim of this study was to assess the influence of tobacco exposure, at the time of diagnosis, on the disease-related outcomes of patients with tobacco-associated superficial transitional cell carcinoma (TCC) of the bladder. METHODS. A retrospective cohort study was performed using the MSKCC Registry to identify all institutional cases of 'noninvasive' TCC (n = 1632) between 1985 and 1995. After employing exclusion criteria, 286 cases of incident tobacco-associated superficial TCC were divided into 3 strata of tobacco exposure (127 ex-smokers, 51 quitters, and 108 continued smokers) by chart review and post hoc questionnaires (n = 82). Measured outcomes included recurrence free survival and survival free of adverse events (defined a priori as disease progression or other urinary tract TCC). RESULTS. There were no significant differences among ex-smokers, quitters, and continued smokers in terms of stage, grade, tumor size, multifocality, up-front bacillus Calmette-Guerin therapy, or median follow-up. Ex-smokers presented at a later age than individuals who continued to smoke. Post hoc questionnaires and chart reviews were compared in terms of smoking status at time of diagnosis, and reliability was excellent (κ = 0.89). Multivariate analyses revealed diminished recurrence free survival among continued smokers versus quitters or ex-smokers. Univariate analyses revealed diminished adverse event free survival among continued smokers versus quitters or ex- smokers. Multivariate models assessing adverse event free survival revealed a similar trend (P = 0.06). CONCLUSIONS. Continued smokers experience worse disease-associated outcomes than patients who quit smoking. Smoking cessation should thus be employed as a tertiary prevention strategy for patients with superficial TCC.
Keywords:	adult; cancer survival; controlled study; treatment outcome; aged; middle aged; survival analysis; major clinical study; cigarette smoking; disease association; cohort studies; neoplasm recurrence, local; risk factors; smoking cessation; smoking; urinary bladder neoplasms; outcome assessment (health care); questionnaire; disease progression; outcomes research; cancer registry; epidemiology; tobacco; carcinoma, transitional cell; bladder carcinoma; transitional cell carcinoma; disease recurrence; exposure; superficial cancer; humans; human; male; female; priority journal; article
Journal Title:	Cancer
Volume:	86
Issue:	11
ISSN:	0008-543X
Publisher:	Wiley Blackwell
Date Published:	1999-12-01
Start Page:	2337
End Page:	2345
Language:	English
DOI:	10.1002/(sici)1097-0142(19991201)86:11<2337::aid-cncr23>3.0.co;2-6
PUBMED:	10590376
PROVIDER:	scopus
DOI/URL:	https://www.scopus.com/inward/record.uri?eid=2-s2.0-0033429879&partnerID=40&md5=c4d5565f7341a2f031491abdc7127f86
Notes:	Article -- Export Date: 16 August 2016 -- Source: Scopus

https://synapse.mskcc.org/synapse/works/has_related_data_chk/96013