Login to Access Video or Poster Abstract: MP21-07
Sources of Funding: none

Introduction

The impact of smoking on mortality in patients with bladder cancer is subject to controversies.

Methods

We investigated 1000 patients who consecutively underwent radical cystectomy between 1993 and 2013. Proportional hazard models for competing risks were used to study combined effects of variables on bladder cancer and competing mortality.

Results

The median follow-up in the survivors was 6.6 years; 331 patients had died from bladder cancer, 178 from non-cancer or unknown (n=6) causes and 54 from a second cancer. Compared with non-smokers, current smokers were more frequently male (35.7% versus 12.0%, p<0.0001), younger (63.5 versus 70.5 years, p<0.0001), had a lower body mass index (26.2 versus 27.1 kg/m2, p<0.0001) and suffered less frequently from cardiac insufficiency (12.7% versus 19.3%, p=0.0129). In current smokers there was a trend towards lower bladder cancer and higher competing mortality compared with non-smokers. In the multivariable analysis, current smoking was no predictor of bladder cancer mortality (hazard ratio, HR, in the full model 0.76, p=0.0687) but of competing mortality (HR in the optimal model 1.62, p=0.0044).

Conclusions

This study did not confirm adverse bladder cancer-related outcome in current smokers after radical cystectomy. With a younger mean age and a male predominance, current smokers showed a trend towards lower bladder cancer mortality that was eventually neutralized by increased competing mortality illustrating that selection effects may explain some smoking-related outcome differences after radical cystectomy.

Funding

none