Heavy Cigarette Smoking and Aggressive XXXX at Initial Presentation.

@entity1 @entity286 @entity5 @entity1358 @entity150 @entity811
OBJECTIVE: To identify the impact of smoking intensity on @entity5 characteristics at the time of initial @entity150 diagnosis. METHODS: We retrospectively reviewed our institution's prospective database of @entity1 diagnosed with @entity150 from 1987 to 2009. Only @entity1 with @entity1358 and recorded @entity286 history were included. @entity1 were stratified by @entity286 history into nonsmokers, light smokers ( <=30 pack-years), and heavy smokers (>30 pack-years). An additional analysis was performed looking at @entity1 meeting National Lung Cancer Screening Trial (NLCST) criteria (55- to 74-year-old @entity1 with  >= 30 pack-years smoking history and  <15  years since smoking cessation). Clinicopathologic characteristics of the initial @entity150 at time of diagnosis were analyzed. RESULTS: We identified 197 (26.6%) nonsmokers, 251 (33.9%) light smokers, and 292 (39.5%) heavy smokers. Males were more likely to be heavy smokers (44.5% vs 23.6%, P   <=.01). Compared with nonsmokers and light smokers, the @entity5 in heavy smokers were more likely to be high grade with a more advanced clinical stage. Heavy smokers were more likely to present with muscle-invasive @entity150 (MIBC) at initial diagnosis. When compared to nonsmokers, the odds ratio for presenting with MIBC was 1.18 (95% confidence interval  = 0.68-2.1) for light smokers and 1.38 (95% confidence interval  = 1.06-1.8) for heavy smokers. Of 793 @entity1 with adequate information for analysis, 184 (23.2%) met NLCST criteria. Those meeting NLCST criteria were most likely to be male, to present with gross @entity811 , and to have @entity5 that were high grade and muscle invasive. NLCST criteria eligibility remained associated with MIBC on multivariate analysis. CONCLUSION: Heavy smokers and @entity1 meeting NLCST criteria are more likely to have high-grade @entity5 with detrusor muscle invasion at initial presentation.
