Roberto Contieri, Francesco Claps, Rodolfo Hurle, Nicolò Maria Buffi, Giovanni Lughezzani, Massimo Lazzeri, Achille Aveta, Savio Pandolfo, Francesco Porpiglia, Cristian Fiori, Biagio Barone, Felice Crocetto, Pasquale Ditonno, Giuseppe Lucarelli, Francesco Lasorsa, Gian Maria Busetto, Ugo Falagario, Francesco Del Giudice, Martina Maggi, Francesco Cantiello, Marco Borghesi, Carlo Terrone, Pierluigi Bove, Alessandro Antonelli, Alessandro Veccia, Andrea Mari, Stefano Luzzago, Ciprian Todea-Moga, Andrea Minervini, Gennaro Musi, Giuseppe Fallara, Francesco Alessandro Mistretta, Roberto Bianchi, Marco Tozzi, Francesco Soria, Paolo Gontero, Michele Marchioni, Letizia M I Janello, Daniela Terracciano, Giorgio I Russo, Luigi Schips, Sisto Perdonà, Octavian S Tataru, Mihai D Vartolomei, Riccardo Autorino, Michele Catellani, Chiara Sighinolfi, Emanuele Montanari, Savino M Di Stasi, Bernardo Rocco, Ottavio de Cobelli, Matteo Ferro
{"title":"吸烟对接受卡介苗治疗的高危和极高危非肌层浸润性膀胱癌患者病情进展的影响。","authors":"Roberto Contieri, Francesco Claps, Rodolfo Hurle, Nicolò Maria Buffi, Giovanni Lughezzani, Massimo Lazzeri, Achille Aveta, Savio Pandolfo, Francesco Porpiglia, Cristian Fiori, Biagio Barone, Felice Crocetto, Pasquale Ditonno, Giuseppe Lucarelli, Francesco Lasorsa, Gian Maria Busetto, Ugo Falagario, Francesco Del Giudice, Martina Maggi, Francesco Cantiello, Marco Borghesi, Carlo Terrone, Pierluigi Bove, Alessandro Antonelli, Alessandro Veccia, Andrea Mari, Stefano Luzzago, Ciprian Todea-Moga, Andrea Minervini, Gennaro Musi, Giuseppe Fallara, Francesco Alessandro Mistretta, Roberto Bianchi, Marco Tozzi, Francesco Soria, Paolo Gontero, Michele Marchioni, Letizia M I Janello, Daniela Terracciano, Giorgio I Russo, Luigi Schips, Sisto Perdonà, Octavian S Tataru, Mihai D Vartolomei, Riccardo Autorino, Michele Catellani, Chiara Sighinolfi, Emanuele Montanari, Savino M Di Stasi, Bernardo Rocco, Ottavio de Cobelli, Matteo Ferro","doi":"10.1016/j.urolonc.2024.11.015","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>The nonmuscle invasive bladder cancer treated with BCG instillations in patients who smoke could potentially lead to poorer oncological results in the light of the new EAU risk groups classification for NMIBC that did not include BCG treated patients or smoking status.</p><p><strong>Patient and methods: </strong>Outcomes from 1313 patients with nonmuscle invasive bladder cancer treated with TURBT, re-TURBT and BCG instillations at 13 academic hospital centers, since 2002, has been included in this retrospective study. The study variables, including cumulative smoking exposure have been analyzed. A multivariable Cox proportional hazard model was used to assess associations between smoking variables and disease progression and repeated in the EAU high risk and very high-risk group. The statistical significance threshold was set at 0.05, and the statistical analysis was performed using Stata/SE version 17 (StataCorp, College Station, TX, USA).</p><p><strong>Results: </strong>Cox regression analysis revealed in 1313 patients diagnosed with T1G3 NMIBC that patients with a history of heavy and long-term smoking faced a more than twofold increased risk of disease progression compared to nonsmoker patients (HR 2.35; 95% CI: 1.7-3.2; P < 0.01) and a significantly poorer PFS for patients with a history of heavy long-term smoke exposure (P < 0.01). Patients with heavy long-term smoking exposure according to the EAU21 high-risk group had a PFS comparable to very high-risk patients and high-risk patients with heavy long-term smoking exposure showed a higher risk of progression when compared to the high-risk group (HR 1.4; 95% CI: 1.3-1.6; P < 0.01).</p><p><strong>Conclusions: </strong>This study adds valuable information on the relationship between smoking and the progression of NMIBC and BCG therapy. The findings emphasize the need for healthcare providers to consider a patient's smoking history when managing NMIBC and express the need for individualized smoking cessation counseling and individualized treatment approach.</p>","PeriodicalId":23408,"journal":{"name":"Urologic Oncology-seminars and Original Investigations","volume":" ","pages":""},"PeriodicalIF":2.4000,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Impact of smoking exposure on disease progression in high risk and very high-risk nonmuscle invasive bladder cancer patients undergoing BCG therapy.\",\"authors\":\"Roberto Contieri, Francesco Claps, Rodolfo Hurle, Nicolò Maria Buffi, Giovanni Lughezzani, Massimo Lazzeri, Achille Aveta, Savio Pandolfo, Francesco Porpiglia, Cristian Fiori, Biagio Barone, Felice Crocetto, Pasquale Ditonno, Giuseppe Lucarelli, Francesco Lasorsa, Gian Maria Busetto, Ugo Falagario, Francesco Del Giudice, Martina Maggi, Francesco Cantiello, Marco Borghesi, Carlo Terrone, Pierluigi Bove, Alessandro Antonelli, Alessandro Veccia, Andrea Mari, Stefano Luzzago, Ciprian Todea-Moga, Andrea Minervini, Gennaro Musi, Giuseppe Fallara, Francesco Alessandro Mistretta, Roberto Bianchi, Marco Tozzi, Francesco Soria, Paolo Gontero, Michele Marchioni, Letizia M I Janello, Daniela Terracciano, Giorgio I Russo, Luigi Schips, Sisto Perdonà, Octavian S Tataru, Mihai D Vartolomei, Riccardo Autorino, Michele Catellani, Chiara Sighinolfi, Emanuele Montanari, Savino M Di Stasi, Bernardo Rocco, Ottavio de Cobelli, Matteo Ferro\",\"doi\":\"10.1016/j.urolonc.2024.11.015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>The nonmuscle invasive bladder cancer treated with BCG instillations in patients who smoke could potentially lead to poorer oncological results in the light of the new EAU risk groups classification for NMIBC that did not include BCG treated patients or smoking status.</p><p><strong>Patient and methods: </strong>Outcomes from 1313 patients with nonmuscle invasive bladder cancer treated with TURBT, re-TURBT and BCG instillations at 13 academic hospital centers, since 2002, has been included in this retrospective study. The study variables, including cumulative smoking exposure have been analyzed. A multivariable Cox proportional hazard model was used to assess associations between smoking variables and disease progression and repeated in the EAU high risk and very high-risk group. The statistical significance threshold was set at 0.05, and the statistical analysis was performed using Stata/SE version 17 (StataCorp, College Station, TX, USA).</p><p><strong>Results: </strong>Cox regression analysis revealed in 1313 patients diagnosed with T1G3 NMIBC that patients with a history of heavy and long-term smoking faced a more than twofold increased risk of disease progression compared to nonsmoker patients (HR 2.35; 95% CI: 1.7-3.2; P < 0.01) and a significantly poorer PFS for patients with a history of heavy long-term smoke exposure (P < 0.01). Patients with heavy long-term smoking exposure according to the EAU21 high-risk group had a PFS comparable to very high-risk patients and high-risk patients with heavy long-term smoking exposure showed a higher risk of progression when compared to the high-risk group (HR 1.4; 95% CI: 1.3-1.6; P < 0.01).</p><p><strong>Conclusions: </strong>This study adds valuable information on the relationship between smoking and the progression of NMIBC and BCG therapy. The findings emphasize the need for healthcare providers to consider a patient's smoking history when managing NMIBC and express the need for individualized smoking cessation counseling and individualized treatment approach.</p>\",\"PeriodicalId\":23408,\"journal\":{\"name\":\"Urologic Oncology-seminars and Original Investigations\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2024-12-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Urologic Oncology-seminars and Original Investigations\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1016/j.urolonc.2024.11.015\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"ONCOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Urologic Oncology-seminars and Original Investigations","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1016/j.urolonc.2024.11.015","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"ONCOLOGY","Score":null,"Total":0}
Impact of smoking exposure on disease progression in high risk and very high-risk nonmuscle invasive bladder cancer patients undergoing BCG therapy.
Introduction: The nonmuscle invasive bladder cancer treated with BCG instillations in patients who smoke could potentially lead to poorer oncological results in the light of the new EAU risk groups classification for NMIBC that did not include BCG treated patients or smoking status.
Patient and methods: Outcomes from 1313 patients with nonmuscle invasive bladder cancer treated with TURBT, re-TURBT and BCG instillations at 13 academic hospital centers, since 2002, has been included in this retrospective study. The study variables, including cumulative smoking exposure have been analyzed. A multivariable Cox proportional hazard model was used to assess associations between smoking variables and disease progression and repeated in the EAU high risk and very high-risk group. The statistical significance threshold was set at 0.05, and the statistical analysis was performed using Stata/SE version 17 (StataCorp, College Station, TX, USA).
Results: Cox regression analysis revealed in 1313 patients diagnosed with T1G3 NMIBC that patients with a history of heavy and long-term smoking faced a more than twofold increased risk of disease progression compared to nonsmoker patients (HR 2.35; 95% CI: 1.7-3.2; P < 0.01) and a significantly poorer PFS for patients with a history of heavy long-term smoke exposure (P < 0.01). Patients with heavy long-term smoking exposure according to the EAU21 high-risk group had a PFS comparable to very high-risk patients and high-risk patients with heavy long-term smoking exposure showed a higher risk of progression when compared to the high-risk group (HR 1.4; 95% CI: 1.3-1.6; P < 0.01).
Conclusions: This study adds valuable information on the relationship between smoking and the progression of NMIBC and BCG therapy. The findings emphasize the need for healthcare providers to consider a patient's smoking history when managing NMIBC and express the need for individualized smoking cessation counseling and individualized treatment approach.
期刊介绍：
Urologic Oncology: Seminars and Original Investigations is the official journal of the Society of Urologic Oncology. The journal publishes practical, timely, and relevant clinical and basic science research articles which address any aspect of urologic oncology. Each issue comprises original research, news and topics, survey articles providing short commentaries on other important articles in the urologic oncology literature, and reviews including an in-depth Seminar examining a specific clinical dilemma. The journal periodically publishes supplement issues devoted to areas of current interest to the urologic oncology community. Articles published are of interest to researchers and the clinicians involved in the practice of urologic oncology including urologists, oncologists, and radiologists.
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