title: Cigarette smoking status at diagnosis and recurrence in intermediate-risk non-muscle-invasive bladder carcinoma.
abstract: OBJECTIVE
  To study the effect of smoking status at diagnosis on recurrence in intermediate-risk non-muscle-invasive bladder carcinoma treated by transurethral resection (TUR) of the bladder and early intravesical chemotherapy.
  
  
  METHODS
  Tumor characteristics and smoking status were recorded in 395 patients entered in a randomized multicenter trial comparing 2 different schedules of early intravesical chemotherapy. All patients received intravesical epirubicin (80 mg/50 mL) within 6 hours after TUR, followed by 5 more weekly instillations with (arm B) or without (arm A) monthly instillations for 1 year. Smoking habit was investigated at diagnosis through a structured questionnaire. Multivariate statistical analysis was performed to study the recurrence-free survival (RFS) and the recurrence-free rate (RFR) in relation to smoking status.
  
  
  RESULTS
  Ninety-seven (24.6%) patients never smoked and 298 (75.4%) were smokers. At a median follow-up of 48 months, 117 patients (29.6%) recurred, 63 in arm A and 54 in arm B (P = .43). Ten patients (2.5%) progressed. The 3-year RFS, RFR, and median time to first recurrence of smokers and patients who never smoked were 64.0% and 71.3% (P = .08), 69.1% and 74.2% (P = .16), and 13.6 and 14.2 months (P = .27), respectively. The multivariate analysis identified previous history (P = .01) and smoking status (P = .04) as the main prognostic factors for recurrence in these patients. No difference in recurrence risk at 3 years was detected between current and former smokers.
  
  
  CONCLUSIONS
  In intermediate-risk non-muscle-invasive bladder carcinoma treated by early intravesical chemotherapy, smoking status influences significantly the 3-year RFS. No difference was detected between current and former smokers.
authors: Section of Urology, Maternal-Infant, Andrology and Urology Department, University of Palermo, Italy. vserretta@libero.it
authors: Vincenzo
authors: V
authors: Serretta
authors: Vincenzo
authors: V
authors: Altieri
authors: Giuseppe
authors: G
authors: Morgia
authors: Alessandra
authors: A
authors: Di Lallo
authors: Giuseppe
authors: G
authors: Carrieri
authors: Rosalinda
authors: R
authors: Allegro
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000903:Antibiotics, Antineoplastic / Q000627:therapeutic use; D002277:Carcinoma / Q000473:pathology / Q000628:therapy*; D003131:Combined Modality Therapy; D015653:Cystectomy; D018572:Disease-Free Survival; D015251:Epirubicin / Q000627:therapeutic use; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology* / Q000209:etiology; D016016:Proportional Hazards Models; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology*; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000473:pathology / Q000628:therapy*
chemical_list: D000903:Antibiotics, Antineoplastic; D015251:Epirubicin