Smoking behavior and survival outcomes in bladder cancer patients

Purpose: The purpose of this study was to compare the survival outcomes of bladder cancer patients with different smoking behaviors. Materials and Methods: Between January 2011 and December 2014, a total of 565 bladder cancer patients were included from one institute retrospectively. Regarding smoking behavior, among these patients, 337 were nonsmokers, 52 were "quitters" (patients who had quit smoking >= 10 years ago), 54 were ex-smokers (patients who had quit smoking <10 years ago), and 117 were current smokers. We compared the clinicopathological characteristics and survival outcomes among these four groups. Results: In this cohort, the 3-year overall survival (OS) (95% confidence interval [CI]) of the nonsmoker, quitter, ex-smoker, and current smoker groups were 75.6% (95% CI: 72.9%-78.3%), 67.4% (95% CI: 59.8%-75%), 84.1% (95% CI: 78.9%-89.3%), and 83.2% (95% CI: 79.3%-87.1%), respectively. Nonsmoker patients included a higher number of females, and quitters were older than the patients in the other groups. Larger tumors in quitters and higher clinical stages in ex-smokers were observed more frequently than in the patients of the other groups. Compared with nonsmokers, quitters, and ex-smokers, current smokers had no impact on OS (P = 0.541, 0.406, and 0.175, respectively) nor on cancer-specific survival (CSS) (P = 0.631, 0.388, and 0.193, respectively). Higher diagnostic age, being underweight, larger tumor sizes, and higher clinical stages were independent factors predicting OS. Conclusion: Smoking behavior seemed to not directly contribute to the deterioration of overall or CSS duration in patients with bladder cancer.