Cigarette smoking is associated with adverse pathological response and increased disease recurrence amongst patients with muscle-invasive bladder cancer treated with cisplatin-based neoadjuvant chemotherapy and radical cystectomy: a single-centre experience

Luca Boeri, Matteo Soligo, Igor Frank, Stephen A. Boorjian, Robert H. Thompson, Matthew Tollefson, Fernando J. Quevedo, John Cheville, Robert Jeffrey Karnes

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Objective: To investigate the association between smoking status and pathological response to cisplatin-based neoadjuvant chemotherapy (NAC) and survival outcomes in patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy (RC). Patients and Methods: We reviewed 201 patients treated with NAC and RC for cT2–cT4N0M0 BC between 01/1999 and 01/2015. Smoking status was categorised as: ‘never', ‘former', and ‘current' smoker. Pathological response to NAC was defined as: complete (ypT0N0), partial (ypTis/Ta/T1, N0), and no response (ypT2–4 or ypN+). Clinicopathological characteristics were analysed according to smoking status. Logistic regression analyses tested the association between smoking status and pathological response to NAC. Cox regression analyses tested risk factors associated with recurrence, overall (OM) and cancer-specific mortality (CSM). Results: Overall, there were 58 (28.9%) never smokers, 87 (43.3%) former smokers, and 56 (27.9%) current smokers. No response to NAC was more frequently noted in current smokers (73.2%; P = 0.007). Former smoker (odds ratio [OR] 2.28; P = 0.024) and current smoker statuses (OR 4.52; P < 0.001) were significantly associated with no response to NAC, after adjusting for age, gender, Charlson Comorbidity Index, and clinical stage. Similarly, current smoking status (hazard ratio [HR] 2.14; P = 0.03) and extravesical pathological tumour stage (HR 3.31; P < 0.001) were independently associated with an increased risk of recurrence after RC. Conclusion: Cigarette smoking was significantly associated with adverse pathological response to cisplatin-based NAC in patients with MIBC treated with RC. Current smokers were at significantly higher risk of disease recurrence as compared to former and never smokers.

Original languageEnglish (US)
JournalBJU International
DOIs
StateAccepted/In press - Jan 1 2019

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Cystectomy
Urinary Bladder Neoplasms
Cisplatin
Smoking
Recurrence
Drug Therapy
Muscles
Odds Ratio
Regression Analysis
Comorbidity
Neoplasms
Logistic Models
Survival
Mortality

Keywords

  • #Bladder Cancer
  • #blcsm
  • #uroonc
  • bladder cancer
  • cigarette smoking
  • cisplatin
  • disease recurrence
  • neoadjuvant chemotherapy
  • pathologic response

ASJC Scopus subject areas

  • Urology

Cite this

Cigarette smoking is associated with adverse pathological response and increased disease recurrence amongst patients with muscle-invasive bladder cancer treated with cisplatin-based neoadjuvant chemotherapy and radical cystectomy : a single-centre experience. / Boeri, Luca; Soligo, Matteo; Frank, Igor; Boorjian, Stephen A.; Thompson, Robert H.; Tollefson, Matthew; Quevedo, Fernando J.; Cheville, John; Karnes, Robert Jeffrey.

In: BJU International, 01.01.2019.

Research output: Contribution to journalArticle

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title = "Cigarette smoking is associated with adverse pathological response and increased disease recurrence amongst patients with muscle-invasive bladder cancer treated with cisplatin-based neoadjuvant chemotherapy and radical cystectomy: a single-centre experience",
abstract = "Objective: To investigate the association between smoking status and pathological response to cisplatin-based neoadjuvant chemotherapy (NAC) and survival outcomes in patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy (RC). Patients and Methods: We reviewed 201 patients treated with NAC and RC for cT2–cT4N0M0 BC between 01/1999 and 01/2015. Smoking status was categorised as: ‘never', ‘former', and ‘current' smoker. Pathological response to NAC was defined as: complete (ypT0N0), partial (ypTis/Ta/T1, N0), and no response (ypT2–4 or ypN+). Clinicopathological characteristics were analysed according to smoking status. Logistic regression analyses tested the association between smoking status and pathological response to NAC. Cox regression analyses tested risk factors associated with recurrence, overall (OM) and cancer-specific mortality (CSM). Results: Overall, there were 58 (28.9{\%}) never smokers, 87 (43.3{\%}) former smokers, and 56 (27.9{\%}) current smokers. No response to NAC was more frequently noted in current smokers (73.2{\%}; P = 0.007). Former smoker (odds ratio [OR] 2.28; P = 0.024) and current smoker statuses (OR 4.52; P < 0.001) were significantly associated with no response to NAC, after adjusting for age, gender, Charlson Comorbidity Index, and clinical stage. Similarly, current smoking status (hazard ratio [HR] 2.14; P = 0.03) and extravesical pathological tumour stage (HR 3.31; P < 0.001) were independently associated with an increased risk of recurrence after RC. Conclusion: Cigarette smoking was significantly associated with adverse pathological response to cisplatin-based NAC in patients with MIBC treated with RC. Current smokers were at significantly higher risk of disease recurrence as compared to former and never smokers.",
keywords = "#Bladder Cancer, #blcsm, #uroonc, bladder cancer, cigarette smoking, cisplatin, disease recurrence, neoadjuvant chemotherapy, pathologic response",
author = "Luca Boeri and Matteo Soligo and Igor Frank and Boorjian, {Stephen A.} and Thompson, {Robert H.} and Matthew Tollefson and Quevedo, {Fernando J.} and John Cheville and Karnes, {Robert Jeffrey}",
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T1 - Cigarette smoking is associated with adverse pathological response and increased disease recurrence amongst patients with muscle-invasive bladder cancer treated with cisplatin-based neoadjuvant chemotherapy and radical cystectomy

T2 - a single-centre experience

AU - Boeri, Luca

AU - Soligo, Matteo

AU - Frank, Igor

AU - Boorjian, Stephen A.

AU - Thompson, Robert H.

AU - Tollefson, Matthew

AU - Quevedo, Fernando J.

AU - Cheville, John

AU - Karnes, Robert Jeffrey

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: To investigate the association between smoking status and pathological response to cisplatin-based neoadjuvant chemotherapy (NAC) and survival outcomes in patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy (RC). Patients and Methods: We reviewed 201 patients treated with NAC and RC for cT2–cT4N0M0 BC between 01/1999 and 01/2015. Smoking status was categorised as: ‘never', ‘former', and ‘current' smoker. Pathological response to NAC was defined as: complete (ypT0N0), partial (ypTis/Ta/T1, N0), and no response (ypT2–4 or ypN+). Clinicopathological characteristics were analysed according to smoking status. Logistic regression analyses tested the association between smoking status and pathological response to NAC. Cox regression analyses tested risk factors associated with recurrence, overall (OM) and cancer-specific mortality (CSM). Results: Overall, there were 58 (28.9%) never smokers, 87 (43.3%) former smokers, and 56 (27.9%) current smokers. No response to NAC was more frequently noted in current smokers (73.2%; P = 0.007). Former smoker (odds ratio [OR] 2.28; P = 0.024) and current smoker statuses (OR 4.52; P < 0.001) were significantly associated with no response to NAC, after adjusting for age, gender, Charlson Comorbidity Index, and clinical stage. Similarly, current smoking status (hazard ratio [HR] 2.14; P = 0.03) and extravesical pathological tumour stage (HR 3.31; P < 0.001) were independently associated with an increased risk of recurrence after RC. Conclusion: Cigarette smoking was significantly associated with adverse pathological response to cisplatin-based NAC in patients with MIBC treated with RC. Current smokers were at significantly higher risk of disease recurrence as compared to former and never smokers.

AB - Objective: To investigate the association between smoking status and pathological response to cisplatin-based neoadjuvant chemotherapy (NAC) and survival outcomes in patients with muscle-invasive bladder cancer (MIBC) treated with radical cystectomy (RC). Patients and Methods: We reviewed 201 patients treated with NAC and RC for cT2–cT4N0M0 BC between 01/1999 and 01/2015. Smoking status was categorised as: ‘never', ‘former', and ‘current' smoker. Pathological response to NAC was defined as: complete (ypT0N0), partial (ypTis/Ta/T1, N0), and no response (ypT2–4 or ypN+). Clinicopathological characteristics were analysed according to smoking status. Logistic regression analyses tested the association between smoking status and pathological response to NAC. Cox regression analyses tested risk factors associated with recurrence, overall (OM) and cancer-specific mortality (CSM). Results: Overall, there were 58 (28.9%) never smokers, 87 (43.3%) former smokers, and 56 (27.9%) current smokers. No response to NAC was more frequently noted in current smokers (73.2%; P = 0.007). Former smoker (odds ratio [OR] 2.28; P = 0.024) and current smoker statuses (OR 4.52; P < 0.001) were significantly associated with no response to NAC, after adjusting for age, gender, Charlson Comorbidity Index, and clinical stage. Similarly, current smoking status (hazard ratio [HR] 2.14; P = 0.03) and extravesical pathological tumour stage (HR 3.31; P < 0.001) were independently associated with an increased risk of recurrence after RC. Conclusion: Cigarette smoking was significantly associated with adverse pathological response to cisplatin-based NAC in patients with MIBC treated with RC. Current smokers were at significantly higher risk of disease recurrence as compared to former and never smokers.

KW - #Bladder Cancer

KW - #blcsm

KW - #uroonc

KW - bladder cancer

KW - cigarette smoking

KW - cisplatin

KW - disease recurrence

KW - neoadjuvant chemotherapy

KW - pathologic response

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DO - 10.1111/bju.14612

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