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

Fleshner, Neil; Garland, JoAnne; Moadel, Alyson B.; Herr, Harry W.; Ostroff, Jaimie; Trambert, Renee; O’Sullivan, Rory; Russo, Paul

doi:10.1002/(sici)1097-0142(19991201)86:11<2337::aid-cncr23>3.0.co;2-6

Cited by 161 publications

(69 citation statements)

References 31 publications

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“…International bibliography reports that quitting smoking may lead to a decrease in the risk of bladder cancer recurrence [11,12,16,20,21]. Fleshner et al presented the findings of the follow up in 286 cases of bladder cancer in relation to smoking.…”

Section: Discussionmentioning

confidence: 99%

“…Fleshner et al presented the findings of the follow up in 286 cases of bladder cancer in relation to smoking. They reported that patients who kept on smoking had a shorter recurrence-free survival, in contrast to former smokers, concluding that quitting smoking may be used as quaternary prevention strategy, in patients with nonmuscle invasive bladder cancer [11]. Ostroff et al also studied 224 patients who were under surveillance due to history of bladder cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Even though the substance responsible for bladder cancer in smokers has not yet been identified, it seems that a number of substances, traced in the urine of patients, contribute to the carcinogenetic procedure as either initiators or promoters [8][9][10]. Since secondary prevention through screening, even targeted screening of individuals at high risk, has not yet proven its efficacy, primary prevention through decreasing the exposure to modifiable risk factors seems to be the only viable option [11].…”

Section: Introductionmentioning

confidence: 99%

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Patient awareness of smoking as a risk factor for bladder cancer

et al. 2009

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Patient awareness of smoking as a risk factor for bladder cancer

et al. 2009

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“…Improvement of LC in patients who stopped smoking before radiotherapy is most likely due to better tumor oxygenation as a result of improved oxygen-carrying capacity of hemoglobin due to less carboxyhemoglobin [7,10,11,29]. Studies of NSCLC and other tumors also suggested a negative impact of smoking during radiotherapy [3,8,21,27]. Browman et al reported a significantly better survival for patients who did not smoke during radiotherapy in a retrospective series of 115 head and neck cancer patients [3].…”

Section: Resultsmentioning

confidence: 99%

“…Browman et al reported a significantly better survival for patients who did not smoke during radiotherapy in a retrospective series of 115 head and neck cancer patients [3]. Fleshner et al presented a retrospective study of 286 patients with superficial transitional cell bladder carcinoma and observed that patients who continued smoking had a significantly worse LC than ex-smokers or patients who quitted smoking before radiotherapy [8]. Videtic et al found a significantly better survival for those not smoking during radiotherapy in a series of 215 patients with small cell lung cancer [27].…”

Section: Resultsmentioning

confidence: 99%

Prognostic Impact of VEGF and VEGF Receptor 1 (FLT1) Expression in Patients Irradiated for Stage II/III Non-Small Cell Lung Cancer (NSCLC)

et al. 2010

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Smoking Behaviors and Prognosis in Patients With Non–Muscle-Invasive Bladder Cancer in the Be-Well Study

et al. 2022

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ImportanceTobacco smoking is an established risk factor associated with bladder cancer, yet its impact on bladder cancer prognosis is unclear.ObjectiveTo examine associations of use of tobacco (cigarettes, pipes, and cigars), e-cigarettes, and marijuana with risk of recurrence and progression of non–muscle-invasive bladder cancer (NMIBC) and to explore use of smoking cessation interventions.Design, Setting, and ParticipantsThe Be-Well Study is a prospective cohort study of patients with NMIBC diagnosed from 2015 to 2019 and followed-up for 26.4 months in the Kaiser Permanente Northern and Southern California integrated health care system. Eligibility criteria were age at least 21 years, first NMIBC diagnosis (stages Ta, Tis, or T1), alive, and not in hospice care. Exclusion criteria were previous diagnosis of bladder cancer or other cancer diagnoses within 1 year prior to or concurrent with NMIBC diagnosis. Data were analyzed from April 1 to October 4, 2022.ExposuresUse of cigarettes, pipes, cigars, e-cigarettes, and marijuana was reported in the baseline interview. Use of smoking cessation interventions (counseling and medications) was derived from electronic health records.Main Outcomes and MeasuresHazard ratios (HRs) and 95% CIs of recurrence and progression of bladder cancer were estimated by multivariable Cox proportional hazards regression.ResultsA total of 1472 patients (mean [SD] age at diagnosis, 70.2 [10.8%] years; 1129 [76.7%] male patients) with NMIBC were enrolled at a mean (SD) of 2.3 (1.3) months after diagnosis, including 874 patients (59.4%) who were former smokers and 111 patients (7.5%) who were current cigarette smokers; 67 patients (13.7%) smoked pipes and/or cigars only, 65 patients (4.4%) used e-cigarettes, 363 patients (24.7%) used marijuana. Longer cigarette smoking duration and more pack-years were associated with higher risk of recurrence in a dose-dependent manner, with the highest risks for patients who had smoked for 40 or more years (HR, 2.36; 95% CI, 1.43-3.91) or 40 or more pack-years (HR, 1.97; 95% CI, 1.32-2.95). There was no association of having ever smoked, being a former or current cigarette smoker, and years since quit smoking with recurrence risk. No associations with pipes, cigars, e-cigarettes, or marijuana were found. Of 102 patients offered a smoking cessation intervention, 57 (53.8%) received an interventions after diagnosis, with female patients more likely than male patients to engage in such interventions (23 of 30 female patients [76.7%] vs 34 of 76 male patients [44.7%]; P = .003).Conclusions and RelevanceThese findings suggest that longer duration and more pack-years of cigarette smoking were associated with higher risk of NMIBC recurrence. Cigarette smoking remains a critical exposure before and after diagnosis in survivors of NMIBC.

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

Cited by 161 publications

References 31 publications

Patient awareness of smoking as a risk factor for bladder cancer

Patient awareness of smoking as a risk factor for bladder cancer

Prognostic Impact of VEGF and VEGF Receptor 1 (FLT1) Expression in Patients Irradiated for Stage II/III Non-Small Cell Lung Cancer (NSCLC)

Smoking Behaviors and Prognosis in Patients With Non–Muscle-Invasive Bladder Cancer in the Be-Well Study

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