Significant role for lifetime cigarette smoking in worsening bladder cancer and upper tract urothelial carcinoma prognosis: a meta-analysis

Frits H M van Osch; Sylvia H J Jochems; Frederik J van Schooten; Richard T Bryan; Maurice P Zeegers

doi:10.1016/j.juro.2015.10.139

Significant role for lifetime cigarette smoking in worsening bladder cancer and upper tract urothelial carcinoma prognosis: a meta-analysis

Frits H M van Osch, Sylvia H J Jochems, Frederik J van Schooten, Richard T Bryan, Maurice P Zeegers

Cancer and Genomic Sciences

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Abstract

PURPOSE: Although cigarette smoking is a well-established risk factor for urothelial cancer (UC), its role in UC prognosis is still undetermined. This meta-analysis aimed to quantify the role of lifetime smoking history on bladder cancer recurrence, progression and survival, by pooling available data on non-muscle-invasive bladder cancer (NMIBC), muscle-invasive bladder cancer (MIBC) and upper tract urothelial carcinoma (UTUC).

MATERIALS AND METHODS: A total of 24 studies, comprising data from 13,114 BC and 2,259 UTUC patients, were included in this meta-analysis. Publication bias was addressed through Eggers test and the heterogeneity between studies was assessed by the I(2) test statistic and subgroup analyses.

RESULTS: Current smokers at diagnosis are at an increased risk of developing local recurrences in NMIBC (HR=1.27, 95% C.I. = 1.09-1.46) and smoking MIBC patients are at an increased risk of dying due to BC (HR=1.23, 95% C.I. = 1.02-1.44). In the UTUC population smokers have both an increased risk of recurrence in the operative bed (HR=1.57, 95%C.I. = 1.19-1.95) and of dying due to UTUC (HR=1.53, 95%C.I. = 1.13-1.92). We did not identify significant heterogeneity between included studies.

CONCLUSIONS: The body of evidence is limited due to the absence of prospective studies. However, the results from this meta-analysis unambiguously support the hypothesis that lifetime cigarette smokers are at an increased risk of developing a more malignant type of urothelial carcinoma associated with worse prognosis.

Original language	English
Pages (from-to)	872-879
Journal	Journal of Urology
Volume	195
Issue number	4
Early online date	30 Oct 2015
DOIs	https://doi.org/10.1016/j.juro.2015.10.139
Publication status	Published - 1 Apr 2016

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25 Citations
2 Article

Modelling the complex exposure history of smoking in predicting bladder cancer: a pooled analysis of 15 case-control studies
Van Osch, F., Vlaanderen, J., Jochems, S., Bosetti, C., Polesel, J., Porru, S., Carta, A., Golka, K., Jiang, X., Stern, M., Zhong, W-D., Kellen, E., Pohlabeln, H., Tang, L., Marshall, J., Steineck, G., Karagas, M., Johnson, K., Zhang, Z-F., Taylor, J., & 5 othersLa Vecchia, C., Bryan, R., van Schooten, F-J., Wesselius, A. & Zeegers, M., May 2019, In: Epidemiology. 30, 3, p. 458-465 8 p.
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A stratified meta-analysis of the association between exposure to environmental tobacco smoke during childhood and adulthood and urothelial bladder cancer risk
Van Osch, F., Jochems, S., Wesselius, A., van Schooten, F., Bryan, R. & Zeegers, M., 22 Mar 2018, In: International Journal of Environmental Research and Public Health. 15, 4, 569.
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@article{7ece398c8d364c8887201e775d93d72f,

title = "Significant role for lifetime cigarette smoking in worsening bladder cancer and upper tract urothelial carcinoma prognosis: a meta-analysis",

abstract = "PURPOSE: Although cigarette smoking is a well-established risk factor for urothelial cancer (UC), its role in UC prognosis is still undetermined. This meta-analysis aimed to quantify the role of lifetime smoking history on bladder cancer recurrence, progression and survival, by pooling available data on non-muscle-invasive bladder cancer (NMIBC), muscle-invasive bladder cancer (MIBC) and upper tract urothelial carcinoma (UTUC).MATERIALS AND METHODS: A total of 24 studies, comprising data from 13,114 BC and 2,259 UTUC patients, were included in this meta-analysis. Publication bias was addressed through Eggers test and the heterogeneity between studies was assessed by the I(2) test statistic and subgroup analyses.RESULTS: Current smokers at diagnosis are at an increased risk of developing local recurrences in NMIBC (HR=1.27, 95% C.I. = 1.09-1.46) and smoking MIBC patients are at an increased risk of dying due to BC (HR=1.23, 95% C.I. = 1.02-1.44). In the UTUC population smokers have both an increased risk of recurrence in the operative bed (HR=1.57, 95%C.I. = 1.19-1.95) and of dying due to UTUC (HR=1.53, 95%C.I. = 1.13-1.92). We did not identify significant heterogeneity between included studies.CONCLUSIONS: The body of evidence is limited due to the absence of prospective studies. However, the results from this meta-analysis unambiguously support the hypothesis that lifetime cigarette smokers are at an increased risk of developing a more malignant type of urothelial carcinoma associated with worse prognosis.",

author = "{van Osch}, {Frits H M} and Jochems, {Sylvia H J} and {van Schooten}, {Frederik J} and Bryan, {Richard T} and Zeegers, {Maurice P}",

year = "2016",

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doi = "10.1016/j.juro.2015.10.139",

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T1 - Significant role for lifetime cigarette smoking in worsening bladder cancer and upper tract urothelial carcinoma prognosis

T2 - a meta-analysis

AU - van Osch, Frits H M

AU - Jochems, Sylvia H J

AU - van Schooten, Frederik J

AU - Bryan, Richard T

AU - Zeegers, Maurice P

PY - 2016/4/1

Y1 - 2016/4/1

N2 - PURPOSE: Although cigarette smoking is a well-established risk factor for urothelial cancer (UC), its role in UC prognosis is still undetermined. This meta-analysis aimed to quantify the role of lifetime smoking history on bladder cancer recurrence, progression and survival, by pooling available data on non-muscle-invasive bladder cancer (NMIBC), muscle-invasive bladder cancer (MIBC) and upper tract urothelial carcinoma (UTUC).MATERIALS AND METHODS: A total of 24 studies, comprising data from 13,114 BC and 2,259 UTUC patients, were included in this meta-analysis. Publication bias was addressed through Eggers test and the heterogeneity between studies was assessed by the I(2) test statistic and subgroup analyses.RESULTS: Current smokers at diagnosis are at an increased risk of developing local recurrences in NMIBC (HR=1.27, 95% C.I. = 1.09-1.46) and smoking MIBC patients are at an increased risk of dying due to BC (HR=1.23, 95% C.I. = 1.02-1.44). In the UTUC population smokers have both an increased risk of recurrence in the operative bed (HR=1.57, 95%C.I. = 1.19-1.95) and of dying due to UTUC (HR=1.53, 95%C.I. = 1.13-1.92). We did not identify significant heterogeneity between included studies.CONCLUSIONS: The body of evidence is limited due to the absence of prospective studies. However, the results from this meta-analysis unambiguously support the hypothesis that lifetime cigarette smokers are at an increased risk of developing a more malignant type of urothelial carcinoma associated with worse prognosis.

AB - PURPOSE: Although cigarette smoking is a well-established risk factor for urothelial cancer (UC), its role in UC prognosis is still undetermined. This meta-analysis aimed to quantify the role of lifetime smoking history on bladder cancer recurrence, progression and survival, by pooling available data on non-muscle-invasive bladder cancer (NMIBC), muscle-invasive bladder cancer (MIBC) and upper tract urothelial carcinoma (UTUC).MATERIALS AND METHODS: A total of 24 studies, comprising data from 13,114 BC and 2,259 UTUC patients, were included in this meta-analysis. Publication bias was addressed through Eggers test and the heterogeneity between studies was assessed by the I(2) test statistic and subgroup analyses.RESULTS: Current smokers at diagnosis are at an increased risk of developing local recurrences in NMIBC (HR=1.27, 95% C.I. = 1.09-1.46) and smoking MIBC patients are at an increased risk of dying due to BC (HR=1.23, 95% C.I. = 1.02-1.44). In the UTUC population smokers have both an increased risk of recurrence in the operative bed (HR=1.57, 95%C.I. = 1.19-1.95) and of dying due to UTUC (HR=1.53, 95%C.I. = 1.13-1.92). We did not identify significant heterogeneity between included studies.CONCLUSIONS: The body of evidence is limited due to the absence of prospective studies. However, the results from this meta-analysis unambiguously support the hypothesis that lifetime cigarette smokers are at an increased risk of developing a more malignant type of urothelial carcinoma associated with worse prognosis.

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DO - 10.1016/j.juro.2015.10.139

M3 - Article

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SN - 0022-5347

VL - 195

SP - 872

EP - 879

JO - Journal of Urology

JF - Journal of Urology

IS - 4

ER -

Significant role for lifetime cigarette smoking in worsening bladder cancer and upper tract urothelial carcinoma prognosis: a meta-analysis

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Research output

Modelling the complex exposure history of smoking in predicting bladder cancer: a pooled analysis of 15 case-control studies

A stratified meta-analysis of the association between exposure to environmental tobacco smoke during childhood and adulthood and urothelial bladder cancer risk

Cite this