17 96
Review
–
Bladder
Cancer
Smoking
and
Bladder
Cancer:
A
Systematic Review
of
Risk
and
Outcomes
Michael
Rink
a ,y
, * ,Joseph
J.
Crivelli
b ,y
,
Shahrokh
F.
Shariat
c ,Felix K.
Chun
a ,Edward M. Messing
d ,Mark
S.
Soloway
ea
Department
of Urology, University Medical
Center Hamburg-Eppendorf, Hamburg, Germany;
b
Department
of Urology, Weill
Cornell Medical
College, New
York
Presbyterian
Hospital,
New
York,
NY,
USA;
c
Department
of
Urology, Medical
University
Vienna,
Vienna,
Austria;
d
Department
of
Urology,
School
of
Medicine and Dentistry, University of Rochester Medical Center, Rochester, NY, USA;
e
Department of Urology, Miller
School of Medicine, University of Miami,
Miami,
FL, USA
1.
Introduction
Urothelial
carcinoma
of
the
bladder
(UCB)
is
the
sixth
most
common
cancer
in
both
genders, with
an
estimated
72 570 new
cases and 15 210 deaths
in
the USA
in 2013
[1],
representing a significant burden of morbidity andmortality.
Approximately
three-quarters
of
patients
are
initially
diag-
nosed
with
non–muscle-invasive
bladder
cancer
(NMIBC)
E U R O P E A N U R O L O G Y F O C U S 1 ( 2 0 1 5 ) 1 7 – 2 7ava il abl e
at
www.sc iencedirect.comjourna l
homepage:
www.europeanurology.comArticle
info
Article
history:
Accepted November
27,
2014
Associate
Editor:
Alberto
Briganti
Keywords:
Smoking
Urothelial
carcinoma
Non–muscle-invasive
bladder
cancer
Muscle-invasive
bladder
cancer
Recurrence
Progression
Survival
Radical
cystectomy
Transurethral
resection
Intravesical
therapy
Abstract
Context:
Cigarette
smoking
is
an
established
risk
factor
for
urothelial
carcinoma.
Objective:
To
elucidate
the
association between pretreatment
smoking
status,
cumula-
tive exposure, and
time
since
smoking
cessation and
the development of and outcomes
for
urothelial
carcinoma
of
the
bladder
(UCB)
in
patients
treated with
transurethral
resection
of
the
bladder
(TURBT)
or
radical
cystectomy
(RC).
Evidence
acquisition:
A
literature
search was
performed
in
September
2014
using
the
PubMed and Scopus databases
limited
to articles published
in English
since 1990. Eight
contemporary studies on smoking and UBC development and 26 studies on smoking and
UBC
prognosis met
the
inclusion
criteria.
Evidence
synthesis:
Current cigarette smoking
increases
the risk of UCB
incidence by two
to
fourfold, while
smoking
cessation
attenuates
this
risk.
Smoking
status,
exposure,
and
cessation have an evident
impact on disease recurrence
for patients who undergo TURBT,
with
weaker
associations
between
smoking
and
other
endpoints
for
TURBT
and
RC
patients.
Conclusion:
Retrospective evidence
suggests
that
smoking markedly
increases UCB
risk
and may
lead
to
unfavorable
outcomes
for
patients who
already
have
UCB;
smoking
cessation
can
attenuate
these
undesirable
effects.
Patient summary:
Current evidence proves
that cigarette smoking
is an established
risk
factor
for
the
development
of
urothelial
carcinoma
of
the
bladder
(UCB).
There
is
a
growing
body
of
evidence
that
smoking
negatively
affects
outcomes
for UCB
patients
treated with
transurethral
resection and/or
radical cystectomy, although not uniformly.
Long-term
smoking
cessation
seems
to mitigate
the
detrimental
effects
of
smoking
in
non–muscle-invasive
and muscle-invasive
bladder
cancer.
#
2015 European Association of Urology. Published by Elsevier B.V. All
rights
reserved.
y
These
authors
contributed
equally
to
this
review.
* Corresponding
author.
Department
of
Urology,
University Medical
Center
Hamburg-Eppendorf,
Martinistrasse
52,
20246 Hamburg, Germany.
Tel.
+49
40
741053442;
Fax:
+49
40
741042444.
address:
mrink@uke.de(M.
Rink).
http://dx.doi.org/10.1016/j.euf.2014.11.0012405-4569/
#
2015
European
Association
of Urology.
Published
by
Elsevier
B.V.
All
rights
reserved.