Chen Chung-Hsin, Shun Chia-Tung, Huang Kuo-How, Huang Chao-Yuan, Tsai Yu-Chieh, Yu Hong-Jeng, Pu Yeong-Shiau
Department of Urology, National Taiwan University Hospital, Taipei, Taiwan.
BJU Int. 2007 Aug;100(2):281-6; discussion 286. doi: 10.1111/j.1464-410X.2007.06873.x. Epub 2007 Apr 5.
To evaluate effects of stopping smoking on the outcome of nonmuscle-invasive bladder cancer, as cigarette smoking is a risk factor for bladder cancer and little is known about whether stopping smoking reduces the risk of recurrence or progression.
Between January 1997 and July 2005, 297 men with primary nonmuscle-invasive bladder cancer were treated with transurethral resection (TUR); their smoking status before and after the diagnosis of bladder cancer was obtained by a post hoc questionnaire and interview. 'Quitters' were those who ceased smoking within a year before and 3 months after the diagnosis. Ex-smokers were those who ceased smoking more than a year before diagnosis. Several pathological and clinical variables were compared, with all statistical comparisons being two-sided.
In all, 265 patients completed the questionnaire, including 64 non-smokers, 64 ex-smokers, 59 quitters, and 78 continued smokers. The median follow-up was 38 months. There were no significant differences in the strata of stage, grade, tumour multiplicity, intravesical therapy, or median follow-up duration between the four patient groups. The respective 3-year recurrence-free survival of continued smokers, non-smokers, ex-smokers and quitters was 45%, 57%, 62% and 70%. By multivariate analysis, high-grade, T1-stage, multiple tumours and continued smoking were significant independent predictors for a shorter recurrence-free survival. Quitters had a lower risk of recurrence than did either continued smokers or non-smokers, but had a similar risk to ex-smokers.
Stopping smoking might be associated with a lower recurrence rate for patients with nonmuscle-invasive bladder cancer.
鉴于吸烟是膀胱癌的一个风险因素，而对于戒烟是否能降低复发或进展风险知之甚少，本研究旨在评估戒烟对非肌层浸润性膀胱癌预后的影响。
1997年1月至2005年7月期间，297例原发性非肌层浸润性膀胱癌男性患者接受了经尿道切除术（TUR）；通过事后问卷调查和访谈获取了他们在膀胱癌诊断前后的吸烟状况。“戒烟者”是指在诊断前一年至诊断后3个月内戒烟的患者。已戒烟者是指在诊断前一年以上就已戒烟的患者。比较了几个病理和临床变量，所有统计比较均为双侧检验。
共有265例患者完成了问卷调查，其中包括64例不吸烟者、64例已戒烟者、59例戒烟者和78例持续吸烟者。中位随访时间为38个月。四个患者组在分期、分级、肿瘤多发情况、膀胱内治疗或中位随访时间等方面均无显著差异。持续吸烟者、不吸烟者、已戒烟者和戒烟者各自的3年无复发生存率分别为45%、57%、62%和70%。多因素分析显示，高级别、T1期、多发肿瘤和持续吸烟是无复发生存期较短的显著独立预测因素。戒烟者的复发风险低于持续吸烟者和不吸烟者，但与已戒烟者相似。
戒烟可能与非肌层浸润性膀胱癌患者较低的复发率相关。
