%0 Article
%A Hongda Zhao, 
%A Kang Liu, 
%A Alfonso Crisci, 
%A Ed te Slaa, 
%A Tomonori Habuchi, 
%A Murat Akand, 
%A Chi Fai Ng, 
%A Pilar Laguna, 
%A Jeremy Yuen-Chun Teoh, 
%A Jean de la Rosette, 
%T Impact of smoking status at diagnosis on oncological outcomes of upper-tract urothelial carcinoma
%D 2025
%R 10.1177/17562872251352049
%J THERAPEUTIC ADVANCES IN UROLOGY
%X Background: The evidence supporting personalized surveillance strategies for upper-tract
urothelial carcinoma (UTUC) remains limited. This study seeks to explore how smoking habits
influence the oncological outcomes of UTUC
Methods: Data on disease characteristics from UTUC patients were gathered prospectively.
Recurrence-free survival was the primary outcome measured. Patients were stratified based
on smoking status for Kaplan–Meier and multivariable Cox regression analyses.
Results: A total of 1952 patients were involved, including 684 (35%) patients who never
smoked, 572 (29%) that were ex-smokers, and 696 (36%) that were current smokers. For
female patients, most of them were nonsmokers (n= 328). Current smokers were significantly
younger and had higher American Society of Anesthesiologist (ASA) scores and Charlson
Comorbidity Index. A total of 19.9% (n = 236) of patients developed tumor recurrence.
Kaplan–Meier analyses showed that smoking status was associated with a greater likelihood
of urothelial carcinoma recurrence (p = 0.011) and intravesical recurrence (p = 0.021). The
multivariable Cox regression analysis identified the smoking status as an independent
risk factor for urothelial carcinoma recurrence (p = 0.046). When compared with former
smokers, current smokers showed a higher urothelial carcinoma recurrence (p = 0.016) and
intravesical recurrence (p = 0.006).
Conclusion: Smoking at the time of diagnosis was significantly associated with an increased
risk of tumor recurrence in the bladder but not significantly in the upper urinary tract. This
study confirms that cumulative smoking exposure accelerates the risk of tumor recurrence
and underlines the importance of smoking cessation.
%U https://repo.bashgmu.ru/publication/5528