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首页> 外文期刊>BJU international >Does smoking status influence the prognosis of bladder cancer? A systematic review.
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Does smoking status influence the prognosis of bladder cancer? A systematic review.

机译：吸烟状况会影响膀胱癌的预后吗？系统的审查。

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OBJECTIVE: To summarize, in a systematic review, the evidence for the effect of stopping smoking on recurrence, cancer-specific and all cause-mortality among smokers with newly diagnosed bladder cancer. MATERIALS AND METHODS: Two electronic databases and the reference lists of identified primary studies and reviews were searched. Studies were included if a hazard ratio and its confidence intervals could be extracted. A predefined set of study characteristics was extracted which defined whether studies were giving valid prognostic data on the effects of smoking in reasonably homogenous cohorts. The results of studies were synthesized qualitatively. RESULTS: Fifteen relevant studies were identified; former and current smokers were combined in many studies. Many studies produced information on prognosis that was confounded by the mixing of incident and prevalent cases. Only three studies examined the influence of smoking on prognosis in only incident cases, most of whom had superficial disease. Of these, only one was of high quality. These three studies and the other 12 showed suggestive evidence that continued smoking or a lifetime of smoking constitutes a moderate risk factor for recurrence and death, and that stopping smoking could favourably change this. However, the evidence base for this is weak because of the methodological shortcomings and because most studies' results were not statistically significant. A life-table model showed that if stopping smoking altered the prognosis, the size of the benefit would be clinically worthwhile. CONCLUSION: There is suggestive evidence that stopping smoking might favourably alter the course of bladder cancer, but this is insufficient for clinicians to inform patients that doing so will improve their prognosis, and for providing specialized services to assist in stopping smoking to patients with bladder cancer.
机译：目的：在系统综述中总结戒烟对新诊断膀胱癌的吸烟者复发，癌症特异性和所有致死率的影响的证据。材料与方法：搜索了两个电子数据库以及已确定的基础研究和综述的参考文献清单。如果可以提取危险比及其置信区间，则包括研究。提取了预定义的一组研究特征，这些特征定义了研究是否在合理同质的队列中提供了有关吸烟影响的有效预后数据。研究的结果是定性综合的。结果：确定了十五项相关研究;在许多研究中结合了以前和现在的吸烟者。许多研究产生了与预后相关的信息，这些信息与突发事件和流行病例的混杂相混淆。只有三项研究仅在大多数患有浅表疾病的事件中研究了吸烟对预后的影响。其中，只有一个是高质量的。这三项研究和其他十二项研究表明，继续吸烟或终生吸烟是复发和死亡的中度危险因素，而戒烟可以有利地改变这一状况。但是，由于方法上的缺陷以及大多数研究的结果在统计学上均不显着，因此其证据基础薄弱。生命表模型显示，如果停止吸烟会改变预后，则获益的大小在临床上将是值得的。结论：有证据表明，戒烟可能会有利地改变膀胱癌的病程，但这不足以使临床医生告知患者这样做可以改善其预后，也无法为膀胱癌患者提供专业服务以协助戒烟。

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