Smoking and survival after radical cystectomy for bladder cancer

Objective: To present our long-term follow-up data to investigate whether cigarette smoking is associated with the prognosis of bladder cancer after radical cystectomy. Despite the close link between cigarette smoking and the development of bladder cancer, little is known about the influence of cigarette smoking on the bladder cancer prognosis after radical cystectomy. Materials and Methods: The cigarette smoking status of 602 patients who had undergone radical cystectomy for bladder cancer was determined using questionnaires completed before surgery. The effect of cigarette smoking on recurrence-free survival, cancer-specific survival, and overall survival was determined. Results: Of the 340 patients with a smoking history, 159 were current smokers. The smokers were younger (P =.001) and more likely to be male (P =.001) than were the nonsmokers. The 5-year recurrence-free survival rate of the smokers and nonsmokers was 62.1% and 56.8% (P = .182), the 5-year cancer-specific survival rate was 67.3%, 63.9% (P =.436), and the 5-year overall survival rate was 63.0% and 58.8% (P =.309), respectively. Multivariate analysis revealed that smoking was not an independent predictor of recurrence-free survival or cancer-specific survival. After adjusting for other prognostic variables, cigarette smoking status (non-, ex-, or current smoker), cumulative exposure, and years from smoking cessation were not associated with cancer-specific survival (P =.378, P =.827, and P =.876, respectively). Conclusion: The results of the present study found no association between cigarette smoking and the prognosis of bladder cancer after radical cystectomy.