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• W1829553885 abstract "No AccessJournal of UrologyAdult Urology1 Apr 2016Significant Role of Lifetime Cigarette Smoking in Worsening Bladder Cancer and Upper Tract Urothelial Carcinoma Prognosis: A Meta-Analysis Frits H.M. van Osch, Sylvia H.J. Jochems, Frederik J. van Schooten, Richard T. Bryan, and Maurice P. Zeegers Frits H.M. van OschFrits H.M. van Osch Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom More articles by this author , Sylvia H.J. JochemsSylvia H.J. Jochems Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom More articles by this author , Frederik J. van SchootenFrederik J. van Schooten Department of Pharmacology and Toxicology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands More articles by this author , Richard T. BryanRichard T. Bryan Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom More articles by this author , and Maurice P. ZeegersMaurice P. Zeegers Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.10.139AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract Purpose: Although cigarette smoking is a well established risk factor for urothelial cancer, its role in urothelial cancer prognosis is still undetermined. In this meta-analysis we quantify the role of lifetime smoking history in bladder cancer recurrence, progression and survival by pooling available data on nonmuscle invasive bladder cancer, muscle invasive bladder cancer and upper tract urothelial carcinoma. Materials and Methods: A total of 24 studies, comprising data from 13,114 patients with bladder cancer and 2,259 patients with upper tract urothelial carcinoma, were included in this meta-analysis. Publication bias was addressed through Egger’s test, and the heterogeneity among studies was assessed by the I2 test statistic and subgroup analyses. Results: Current smokers at diagnosis are at increased risk for local recurrence in nonmuscle invasive bladder cancer (HR 1.27, 95% CI 1.09–1.46) and smokers with muscle invasive bladder cancer have an increased risk of dying of bladder cancer (HR 1.23, 95% CI 1.02–1.44). In the upper tract urothelial carcinoma population smokers have an increased risk of recurrence in the operative bed (HR 1.57, 95% CI 1.19–1.95) and of death from upper tract urothelial carcinoma (HR 1.53, 95% CI 1.13–1.92). We did not identify significant heterogeneity among included studies. Conclusions: The body of evidence is limited due to the absence of prospective studies. However, the results from this meta-analysis unambiguously support the hypothesis that lifetime cigarette smokers are at increased risk for a more malignant type of urothelial carcinoma associated with a worse prognosis. References 1 : The impact of characteristics of cigarette smoking on urinary tract cancer risk. Cancer2000; 89: 630. Google Scholar 2 : Effect of smoking on outcomes of urothelial carcinoma: a systematic review of the literature. Eur Urol2014; 65: 742. Google Scholar 3 : Smoking and smoking cessation effects on oncological outcomes in nonmuscle invasive bladder cancer. Curr Opin Urol2014; 24: 492. Google Scholar 4 : Does quantification of smoking history correlate with initial bladder tumor grade and stage?. Curr Urol Rep2014; 15: 1. Google Scholar 5 : Prognostic factors in upper urinary tract urothelial carcinomas: a comprehensive review of the current literature. 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Google Scholar 29 : Impact of smoking on oncologic outcomes of upper tract urothelial carcinoma after radical nephroureterectomy. Eur Urol2013; 63: 1082. Google Scholar 30 : Impact of smoking status at diagnosis on disease recurrence and death in upper tract urothelial carcinoma. BJU Int2013; 111: 589. Google Scholar © 2016 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetailsCited byChang S (2017) Re: The Health Effects of Electronic CigarettesJournal of Urology, VOL. 198, NO. 6, (1207-1207), Online publication date: 1-Dec-2017.Chang S (2017) Re: Refraining from Smoking for 15 Years or More Reduced the Risk of Tumor Recurrence in Non-Muscle Invasive Bladder Cancer PatientsJournal of Urology, VOL. 198, NO. 5, (979-980), Online publication date: 1-Nov-2017. Volume 195Issue 4 Part 1April 2016Page: 872-879Supplementary Materials Advertisement Copyright & Permissions© 2016 by American Urological Association Education and Research, Inc.Keywordssmokingmeta-analysistransitional cellprognosiscarcinomaurinary bladder neoplasmsMetricsAuthor Information Frits H.M. van Osch Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom More articles by this author Sylvia H.J. Jochems Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom More articles by this author Frederik J. van Schooten Department of Pharmacology and Toxicology, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands More articles by this author Richard T. Bryan Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom More articles by this author Maurice P. Zeegers Department of Complex Genetics, NUTRIM School for Nutrition and Translational Research in Metabolism, Maastricht University, Maastricht, The Netherlands Institute of Cancer and Genomic Sciences, University of Birmingham, Birmingham, United Kingdom More articles by this author Expand All Advertisement PDF downloadLoading ..." @default.
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