title: Areca Nut Chewing and an Impaired Estimated Glomerular Filtration Rate as Significant Risk Factors for Non-Muscle-Invasive Bladder Cancer Recurrence.
abstract: The present study sought to investigate the predictive value of preoperative clinicopathological variables, with a special focus on areca nut chewing, on disease recurrence and progression in patients with non-muscle-invasive bladder cancer (NMIBC). Data from 242 patients diagnosed with NMIBC between 2008 and 2013 were analyzed retrospectively. Fifteen clinicopathological variables were analyzed to evaluate their prognostic value. During a mean observation period of 21 months, disease recurrence occurred in 140 patients (57.9%). On multivariate analysis, heavy-areca nut chewing (HR = 2.18, 95% CI: 1.37-3.47), current smoking (HR = 3.09, 95% CI: 1.99-4.80), moderately impaired estimated glomerular filtration rate (eGFR) (HR = 1.76, 95% CI: 1.09-2.83), severely impaired eGFR (HR = 3.32, 95% CI: 1.70-6.48) and tumor grade (HR = 1.94, 95% CI: 1.36-2.77) were independent factors for recurrence, based on which a risk factor model was developed to stratify patients into high, medium and low risk groups. In conclusion, our study suggests that in addition to quitting smoking, quitting areca nut chewing may also reduce the risk of first recurrence in NMBIC patients, monitoring and preserving their renal function may be beneficial as well. Further prospective studies are needed to verify the prognostic significance of these factors and the risk stratification model in this population.
authors.affiliation: Department of Urology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan Province, People's Republic of China.|MRC Centre for Reproductive Health, The Queen's Medical Research Institute, 47 Little France Crescent, Edinburgh EH16 4TJ, United Kingdom.
authors.forename: Jian
authors.initials: J
authors.lastname: Cao
authors.affiliation: Department of Urology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan Province, People's Republic of China.
authors.forename: Ran
authors.initials: R
authors.lastname: Xu
authors.affiliation: Department of Urology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan Province, People's Republic of China.
authors.forename: Xiaokun
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Urology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan Province, People's Republic of China.
authors.forename: Zhaohui
authors.initials: Z
authors.lastname: Zhong
authors.affiliation: Department of Urology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan Province, People's Republic of China.
authors.forename: Lei
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Urology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan Province, People's Republic of China.
authors.forename: Xuan
authors.initials: X
authors.lastname: Zhu
authors.affiliation: Department of Urology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan Province, People's Republic of China.
authors.forename: Shuiqing
authors.initials: S
authors.lastname: Wu
authors.affiliation: Department of Urology, The Second Xiangya Hospital, Central South University, 139 Middle Renmin Road, Changsha 410011, Hunan Province, People's Republic of China.
authors.forename: Kai
authors.initials: K
authors.lastname: Ai
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001114:Areca / Q000009:adverse effects*; D018450:Disease Progression; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008409:Mastication; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D001749:Urinary Bladder Neoplasms / Q000139:chemically induced / Q000453:epidemiology* / Q000473:pathology*