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result(s) for
"te Slaa, Ed"
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Impact of smoking status at diagnosis on oncological outcomes of upper-tract urothelial carcinoma
2025
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.
Trial registration:
NCT02281188.
Plain language summary
The influence of smoking status for patients with UTUC
Based on the CROES-UTUC registry, we confirmed that both previous non-urothelial and urothelial cancers could accelerate the risk of tumour recurrence and, more personalized follow-up plans and active treatment strategies should be considered for UTUC patients.
Journal Article
Optimization of Preoperative Lymph Node Staging in Patients with Muscle-Invasive Bladder Cancer Using Radiomics on Computed Tomography
by
Starmans, Martijn P. A.
,
Klaver, Sjoerd
,
Cauberg, Evelyne C. C.
in
Abdomen
,
Accuracy
,
Bladder cancer
2022
Approximately 25% of the patients with muscle-invasive bladder cancer (MIBC) who are clinically node negative have occult lymph node metastases at radical cystectomy (RC) and pelvic lymph node dissection. The aim of this study was to evaluate preoperative CT-based radiomics to differentiate between pN+ and pN0 disease in patients with clinical stage cT2-T4aN0-N1M0 MIBC. Patients with cT2-T4aN0-N1M0 MIBC, of whom preoperative CT scans and pathology reports were available, were included from the prospective, multicenter CirGuidance trial. After manual segmentation of the lymph nodes, 564 radiomics features were extracted. A combination of different machine-learning methods was used to develop various decision models to differentiate between patients with pN+ and pN0 disease. A total of 209 patients (159 pN0; 50 pN+) were included, with a total of 3153 segmented lymph nodes. None of the individual radiomics features showed significant differences between pN+ and pN0 disease, and none of the radiomics models performed substantially better than random guessing. Hence, CT-based radiomics does not contribute to differentiation between pN+ and pN0 disease in patients with cT2-T4aN0-N1M0 MIBC.
Journal Article