Impact Of Smoking Status And Cumulative Smoking Exposure On Tumor Recurrence Of Non-muscle-invasive Bladder Cancer

Objective: To investigate the effect of smoking status and cumulative smoking exposure on the outcomes of patient with non-muscle-invasive bladder cancer(NMIBC).Methods: We collected clinicopathologic and smoking data from 484 patients with NMIBC who were treated with transurethral resection(TUR).Association with outcomes was examined by multivariable analyses after adjusting for the effects of standard clinicopathologic factors,and the Kaplan-Meier method was used to estimate the effect of smoking status and cumulative smoking exposure on RFS.Results: A total of 484 patients participated in this study: The mean follow-up was 34.1months.Through multivariate analysis,we found that pathological grade,history of recurrence,tumor number and tumor size were significantly associated with tumor recurrence.Nevertheless,smoking status did not significantly influence tumor recurrence(p=0.066).Among current and former smokers,cumulative smoking exposure was significantly associated with tumor recurrence.Compared to current smokers,patients whose smoking cessation ?10 years had a lower risk of tumor recurrence(hazard ratio[HR]:0.500,p = 0.015).Conclusion: The contribution of smoking in the prognosis of NMIBC is still controversial;however,among ever smokers(former and current smokers),a high cumulative exposure smoking can significantly increase the risk of tumor recurrence.Quitting smoking might be associated with a lower recurrence rate.