Impact of smoking status on the recurrence of superficial urinary bladder cancer

Abstract EN

Objectives: The objectives of this study were to assess the association between smoking and the primary characteristics of superficial bladder cancer (SBC) and to investigate the effect of smoking and smoking cessation on the recurrence rate of SBC.

Methods: This was a descriptive comparative study involving 200 patients with Ta or T1 superficial (non-muscle-invasive) urinary bladder cancer who underwent transurethral resection of bladder tumor (TURBT) and surveillance cystoscopy at Prince Hussein Bin Abdullah II Center for Urology and Organ Transplantation between April 2014 and May 2020.

The original smoking status for each patient at the time of diagnosis was recorded, and cystoscopic findings along with histopathologic tumor characteristics were compared between smokers and non-smokers.

Subsequently, the patients were categorized into the following three subgroups: non-smokers, persistent smokers, and quitters who stopped smoking within three months of the initial diagnosis of urinary bladder cancer.

Finally, the recurrence rate of bladder cancer in the surveillance cystoscopy program for each patient was calculated and compared between the different groups.

Results: One hundred seventy-four males and 26 females were included in the study.

We found that smoking was only associated with tumor multicentricity.

One hundred ninety-one patients completed the 5-year study period.

Non-smokers had the lowest recurrence rate and the best recurrence-free survival throughout the study.

While persistent smokers and quitters had similar early recurrence rates, smoking cessation was found to reduce late recurrences.

The median cumulative 5-year recurrence-free survival for non-smokers, quitters, and persistent smokers was 48, 40, and 35 months, respectively.

Conclusion: Since improved late recurrence rates were found in patients who quit smoking, in addition to the negative effects of smoking on general health, smokers with SBC should be thoroughly counseled, encouraged and persuaded regarding smoking cessation to enjoy a better quality of life.