Impact of Smoking on Prognosis and Survival of Patients with Bladder Cancer

Cigarette smoking is the established risk factor for the development of urothelial carcinoma of bladder (UCB). However, the impact of smoking on the outcomes of urothelial carcinoma patients remains poorly investigated. Current evidence proves that cigarette smoking increases the risk of disease recurrence and potentially disease progression in patients with urothelial carcinoma of bladder. Current and heavy long-term smokers seem to be at the greatest risk. The majority of retrospective studies found an association between smoking status as well as cumulative exposure and disease recurrence in patients treated with TURB. The evidence for association with disease progression was less abundant. There are insufficient data investigating the impact on cancer-specific and overall survival in patients with bladder cancer. The impact of smoking with outcomes of T1 UCB or high risk disease, patients receiving intravesical therapies is limited because of a lack of data and controversial findings. Long-term smoking cessation seems to mitigate the detrimental effects of smoking in non-muscle-invasive and muscle-invasive bladder cancer.