Preoperative smoking and robot-assisted radical cystectomy outcomes & complications in multicenter KORARC database

• Published in: Scientific reports 2024-05, Vol.14 (1), p.10550-7, Article 10550
• Main Authors: Choi, Joongwon, Lee, Jooyoung, Hwang, Yu Been, Jeong, Byong Chang, Lee, Sangchul, Ku, Ja Hyeon, Nam, Jong Kil, Kim, Wansuk, Lee, Ji Youl, Hong, Sung Hoo, Rha, Koon Ho, Han, Woong Kyu, Ham, Won Sik, Kang, Sung Gu, Kang, Seok Ho, Oh, Jong Jin, Lee, Young Goo, Kwon, Tae Gyun, Kim, Tae-Hwan, Jeon, Seung Hyun, Lee, Sang Hyub, Park, Sung Yul, Yoon, Young Eun, Lee, Yong Seong
• Format: Article
• Language: English
• Subjects: 631/67/589; 631/67/589/1336; 692/4025/1334; Aged; Bladder cancer; Comparative analysis; Cystectomy; Cystectomy - adverse effects; Cystectomy - methods; Databases, Factual; Female; Humanities and Social Sciences; Humans; Male; Middle Aged; multidisciplinary; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Preoperative Period; Republic of Korea - epidemiology; Retrospective Studies; Robot-assisted surgery; Robotic surgery; Robotic Surgical Procedures - adverse effects; Robotic Surgical Procedures - methods; Robots; Science; Science (multidisciplinary); Smoking; Smoking - adverse effects; Survival; Survival analysis; Treatment Outcome; Urinary Bladder Neoplasms - mortality; Urinary Bladder Neoplasms - pathology; Urinary Bladder Neoplasms - surgery; Urological surgery
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-61005-6

To investigate the influence of preoperative smoking history on the survival outcomes and complications in a cohort from a large multicenter database. Many patients who undergo radical cystectomy (RC) have a history of smoking; however, the direct association between preoperative smoking history and survival outcomes and complications in patients with muscle-invasive bladder cancer (MIBC) who undergo robot-assisted radical cystectomy (RARC) remains unexplored. We conducted a retrospective analysis using data from 749 patients in the Korean Robot-Assisted Radical Cystectomy Study Group (KORARC) database, with an average follow-up duration of 30.8 months. The cohort was divided into two groups: smokers (n = 351) and non-smokers (n = 398). Propensity score matching was employed to address differences in sample size and baseline demographics between the two groups (n = 274, each). Comparative analyses included assessments of oncological outcomes and complications. After matching, smoking did not significantly affect the overall complication rate ( p  = 0.121). Preoperative smoking did not significantly increase the occurrence of complications based on complication type (p = 0.322), nor did it increase the readmission rate (p = 0.076). There were no perioperative death in either group. Furthermore, preoperative smoking history showed no significant impact on overall survival (OS) [hazard ratio (HR) = 0.87, interquartile range (IQR): 0.54–1.42; p  = 0.589] and recurrence-free survival (RFS) (HR = 1.12, IQR: 0.83–1.53; p  = 0.458) following RARC for MIBC. The extent of preoperative smoking (≤ 10, 10–30, and ≥ 30 pack-years) had no significant influence on OS and RFS in any of the categories (all p  > 0.05). Preoperative smoking history did not significantly affect OS, RFS, or complications in patients with MIBC undergoing RARC.