The effect of smoking and timing of smoking cessation on clinical outcome in non-muscle-invasive XXXX .

@entity1 @entity150 @entity65 @entity5
OBJECTIVES: Cigarette smoking is the most important risk factor for @entity150 . The prognostic effect of cigarette smoking on disease recurrence and progression in @entity1 with non-muscle-invasive @entity150 (NMIBC), however, is still unclear. We evaluated the effect of smoking status and intensity, and timing of smoking cessation, on NMIBC prognosis. METHODS AND MATERIALS: A population-based series of @entity1 diagnosed with NMIBC from 1995 until 2010 was identified through the Netherlands Cancer Registry. Self-reported smoking history was obtained by a postal lifestyle questionnaire at study inclusion. Detailed clinical data concerning diagnosis, treatment, and disease course were collected retrospectively through a medical file survey. The association of smoking variables with recurrence- and progression-free survival of 963 @entity1 with primary NMIBC was studied using cumulative incidence curves and competing risk regression analyses. RESULTS: The study population comprised 181 never smokers (18.8%), 490 former smokers (50.9%), and 292 current smokers (30.3%) at the time of diagnosis. No statistically significant difference or trend in risk of recurrence (Ptrend = 0.47) or progression (Ptrend = 0.23) across the 3 smoking status categories was found. Moreover, no dose-response association was observed across categories of smoking quantity, duration, or cumulative exposure in relation to NMIBC prognosis. The timing of smoking cessation (i.e., ceased smoking>= 10y before diagnosis,<10y before diagnosis, vs. current smoker at diagnosis) did not significantly affect the risk of recurrence (Ptrend = 0.31) and progression (Ptrend = 0.19). CONCLUSIONS: Based on our study, smoking status, smoking intensity, or cessation at any time before diagnosis does not seem to alter the risks of recurrence and progression among @entity1 with NMIBC. @entity1 ' smoking history is not useful for the guidance of clinical management decisions. @entity1 should nevertheless be advised to quit considering the known beneficial effects on other non-NMIBC-related end points such as @entity65 and second @entity5 .
