Effect of smoking on adjuvant chemotherapy with GC regimen for upper urinary tract urothelial carcinoma
10.3760/cma.j.cn115396-20240415-00113
- VernacularTitle:吸烟对上尿路尿路上皮癌GC方案辅助化疗的影响
- Author:
Weisi XING
1
;
Ruizhao HUANG
;
Zhiqiang WANG
;
Yun WANG
;
Jing XIAO
Author Information
1. 宁夏医科大学第二临床医学院 银川市第一人民医院泌尿外科，银川 750001
- Keywords:
Smoking;
Neoplasms;
Antineoplastic combined chemotherapy protocols;
Urothelium;
Survival analysis
- From:
International Journal of Surgery
2024;51(10):660-665
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To study the correlation between smoking and clinicopathology in patients with upper tract urothelial carcinoma(UTUC), and to evaluate the effect of smoking on the prognosis of patients with UTUC treated with adjuvant chemotherapy for Gemcitabine plus Cisplatin (GC).Methods:A retrospective cohort study was used to select 91 patients who underwent resection of the kidney and ureter, and sleeve cystectomy in Beijing Friendship Hospital, Capital Medical University from January 2013 to December 2021, all patient received GC adjuvant chemotherapy after surgery. Patients were divided into smoking group ( n=33) and non-smoking group ( n=58) according to their smoking history. The median follow-up time was 38 months (3-83 months). The age, gender, presence or absence of hydronephrosis, tumor stage, multifocality, lymphatic vascular invasion, lymphatic metastasis, tumor grade, overall survival (OS) and cancer-specific survival (CSS) were statistically analyzed. The measurement data were expressed as mean ± standard deviation ( ± s), and the t-test was used for comparison between groups; the count data were expressed as the number of cases and percentage, and the Chi-square test was used for comparison between groups. Kaplan-Meier curve was used for survival analysis and comparison, and Long-rank test was used for comparison between groups. Cox proportional risk regression model was introduced to explore the independent influencing factors of OS and CSS by univariate and multivariate Cox regression analysis. Results:Among 91 patients, 41 were males and 50 were females, with a median age of 65 years, and 19 patients (20.9%) died, of which 17 patients (18.7%) died of UTUC. The comparison of clinical indicators between the two groups showed that smoking was associated with male, tumor stage, multifocality, lymphatic vascular invasion, lymphaitc metastasis, and tumor grade and hydronephrosis ( P<0.05). Multivariate Cox regression analysis showed that smoking, male, higher tumor stage, and lymphatic vascular invasion were independent risk factors for OS and CSS. For the subgroup of patients who smoked, smoking duration significantly affected CSS, with each additional year of smoking duration increasing the risk of death by 0.065. Conclusion:Smoking is associated with adverse pathology in patients with UTUC, and smoking is an independent factor affecting the prognosis of postoperative adjuvant chemotherapy with GC in UTUC.
