THE IMPACT OF SMOKE LOAD ON PROGNOSIS OF NON-MUSCLE INVASIVE UROTHELIAL BLADDER CARCINOMA AFTER BACILLUS CALMETTE–GUERIN (BCG)
Purpose: Smoking habit is the major risk factor for bladder cancer, related to about 50% of these tumors. This study evaluates the impact of smoke load on urothelial bladder carcinoma prognosis after intravesical Bacillus Calmette–Guérin (BCG) when smoking might impact the immune system.
Methods: Smoke load, recurrence, progression and disease specific survival were evaluated in a retrospective study including non-muscle invasive bladder cancer patients treated with intravesical BCG at the Hospital Celso Pierro - PUC Campinas from 2006 to 2015. Multivariate Cox regression and Kaplan-Meier curves were utilized.
Results: Were included 132 patients, 95 (72%) male and 37 (28%) female, being 09 Ta and 123 T1/CIS with mean age 69.6 ± 10.5 years and mean pack-years of smoking 22.0 ± 20.8. Recurrence, progression and disease specific death ocurred in 69 (52.3%, mean time 20.55 ± 20.44), 22 (16.7%, mean time 31.39 ± 20.19) and 11 (8.3%, mean time 37.23 ± 18.34), respectively. Smoke load significantly impact recurrence, p= 0.0004, RR=1.019 (95% CI 1.008-1.030), and progression, p= 0.0002, RR=1.034 (95% CI 1.016-1.052), but not survival.
Conclusion: Smoke load has prognostic role in terms of recurrence and progression in non-muscle invasive urothelial bladder carcinoma after Bacillus Calmette–Guérin (BCG) treatment. Smoking might negatively impact the immune system.
smoke load; bladder cancer; prognosis; BCG treatment
PUC-Campinas - Sao Paulo - Brasil, Unicamp - Sao Paulo - Brasil
Júlia Benedetti , Thaís FN Araújo , Danilo L. Andrade, Leonardo O Reis