Smoking Has Gender-Specific Effect in Urothelial Carcinoma

Smoking Has Gender-Specific Effect in Urothelial Carcinoma
Smoking Has Gender-Specific Effect in Urothelial Carcinoma

For patients with upper tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU), the impact of smoking is gender specific, with worse outcomes for females than for males, according to a study published online ahead of print in BJU International.

Michael Rink, MD, from the New York-Presbyterian Hospital in New York City, and colleagues examined the gender-specific effects of smoking habits and smoking exposure on outcomes in 864 patients (64% male) from five institutions who underwent RNU for UTUC.

Of the cohort, 28.2% were never smokers; 34.4% were former smokers; and 37.4% were current smokers. In univariate analysis, the researchers found that female smokers were significantly more likely to experience disease recurrence compared with men. After adjustment for standard clinico-pathological features, among heavy long-term smokers, female gender was associated with a 70% increased likelihood of disease recurrence and twofold increased risk of cancer-specific mortality. In multivariate analyses, smoking quantity, duration, and cumulative exposure correlated with disease recurrence and cancer-specific mortality for females only.

"Females who are current smokers and have a heavy long-term cumulative smoking exposure are significantly more likely to experience disease recurrence and cancer-specific mortality than their male counterparts," the authors wrote. "The biological mechanisms underlying the gender-specific differential effect of smoking need to be investigated further."

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