Table 3.
Multivariable competing risk regression analyses predicting disease recurrence and cancer-specific mortality in 864 patients with upper tract urothelial carcinoma treated with radical nephroureterectomy according to (a) smoking status and (b) smoking quantity, duration, cumulative smoking exposure, and years since cessation
(a)
| ||||||||
---|---|---|---|---|---|---|---|---|
Variable | HR | Disease recurrence 95% CI | p value | HR | Cancer-specific mortality 95% CI | p value | ||
Lower | Upper | Lower | Upper | |||||
Age | 1.01 | 1.00 | 1.03 | 0.020 | 1.02 | 1.01 | 1.04 | 0.003 |
Female gender | 1.03 | 0.80 | 1.33 | 0.800 | 1.02 | 0.77 | 1.36 | 0.890 |
Ureteral tumor location | 0.82 | 0.62 | 1.10 | 0.190 | 0.88 | 0.63 | 1.23 | 0.460 |
Lymph node metastasis | ||||||||
pNx vs pN0 | 1.23 | 0.92 | 1.63 | 0.160 | 1.24 | 0.89 | 1.72 | 0.200 |
pN+ vs pN0 | 1.95 | 1.32 | 2.89 | <0.001 | 2.51 | 1.61 | 3.91 | <0.001 |
Adjuvant chemotherapy | 1.01 | 0.68 | 1.51 | 0.950 | 1.09 | 0.68 | 1.75 | 0.720 |
Pathologic grade | 2.78 | 1.18 | 6.56 | 0.020 | 2.77 | 0.97 | 7.86 | 0.056 |
Pathologic stage | ||||||||
pT2 vs pT0/a/is/1 | 1.90 | 1.21 | 2.99 | 0.005 | 2.62 | 1.54 | 4.45 | <0.001 |
pT3 vs pT0/a/is/1 | 4.05 | 2.66 | 6.16 | <0.001 | 5.57 | 3.38 | 9.16 | <0.001 |
pT4 vs pT0/a/is/1 | 5.89 | 3.21 | 10.80 | <0.001 | 6.47 | 3.28 | 12.74 | <0.001 |
Sessile tumor architecture | 2.08 | 1.54 | 2.81 | <0.001 | 1.79 | 1.30 | 2.47 | <0.001 |
Tumor necrosis | 0.90 | 0.68 | 1.18 | 0.430 | 0.87 | 0.65 | 1.18 | 0.370 |
Lymphovascular invasion | 1.06 | 0.79 | 1.42 | 0.720 | 1.03 | 0.75 | 1.43 | 0.840 |
Concomitant carcinoma in situ | 1.02 | 0.77 | 1.35 | 0.890 | 0.94 | 0.69 | 1.30 | 0.72 |
Smoking status | ||||||||
Former vs never | 1.39 | 0.97 | 1.98 | 0.070 | 1.48 | 1.01 | 2.17 | 0.044 |
Current vs never | 1.66 | 1.18 | 2.34 | 0.003 | 1.54 | 1.00 | 2.07 | 0.050 |
(b)
| ||||||||
---|---|---|---|---|---|---|---|---|
Variable | HR | Disease recurrence* 95% CI | p value | HR | Cancer-specific mortality* 95% CI | p value | ||
Lower | Upper | Lower | Upper | |||||
Smoking quantity | ||||||||
≤19 CPD vs never | 1.48 | 1.06 | 2.08 | 0.022 | 1.31 | 0.92 | 1.87 | 0.140 |
≥20 CPD vs never | 1.62 | 1.12 | 2.33 | 0.010 | 1.68 | 1.13 | 2.49 | 0.009 |
Smoking duration, yr | ||||||||
≤19 vs never | 1.37 | 0.92 | 2.06 | 0.120 | 1.25 | 0.81 | 1.94 | 0.310 |
≥20 vs never | 1.58 | 1.14 | 2.19 | 0.006 | 1.51 | 1.07 | 2.14 | 0.020 |
Cumulative exposure | ||||||||
Light-short-term vs never | 1.52 | 0.98 | 2.36 | 0.060 | 1.31 | 0.81 | 2.10 | 0.270 |
Moderate vs never | 1.42 | 1.01 | 2.01 | 0.044 | 1.29 | 0.89 | 1.87 | 0.170 |
Heavy-long-term vs never | 1.74 | 1.19 | 2.54 | 0.004 | 1.81 | 1.20 | 2.72 | 0.005 |
HR = hazard ratio; CI = confidence interval; CPD = cigarettes per day.
All models were adjusted for the effects of age (continuous), gender, tumor location, lymph node metastasis (pNx vs pN0 and pN+ vs pN0), adjuvant chemotherapy, pathologic grade, pathologic stage (pT2 vs pT0,a,is,1; pT3 vs pT0,a,is,1; pT4 vs pT0,a,is,1), tumor architecture, tumor necrosis, lymphovascular invasion, and concomitant carcinoma in situ. Cumulative smoking exposure was defined according to the following criteria: light-short-term = ≤19 CPD and ≤19 yr; moderate = ≥20 CPD and ≤19.9 yr or ≤19 CPD and ≥20 yr; heavy-long-term = ≥20 CPD and ≥20 yr.