(HealthDay News) — Smoking is tied to worse bladder cancer outcomes following radical cystectomy, according to a review published online in The Journal of Urology.

Giovanni E. Cacciamani, MD, from the University of Southern California in Los Angeles, and colleagues conducted a systematic literature search to identify studies evaluating tobacco smoking exposure, duration, intensity, and cessation on response to neoadjuvant chemotherapy and long-term survival outcomes in patients undergoing radical cystectomy for bladder cancer.

Based on 17 studies (13,777 patients), a pooled meta-analysis revealed that active smokers had an increased risk for overall mortality (hazard ratio [HR], 1.21), cancer-specific mortality (HR, 1.24), and bladder cancer recurrence (HR, 1.24). When analyzing only patients who underwent neoadjuvant chemotherapy followed by radical cystectomy, nonsmokers and never smokers showed an advantage in terms of neoadjuvant chemotherapy complete response rate compared with active smokers (HR, 0.47).

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“Appropriate preoperative counseling, together with tightened follow-up, may have a pivotal role in improving the smoking-related long-term survival outcomes in patients with bladder cancer,” the authors write.


Cacciamani GE, Ghodoussipour S, Mari A, et al. Association between Smoking Exposure, Neoadjuvant Chemotherapy Response and Survival Outcomes following Radical Cystectomy: Systematic Review and Meta-Analysis. J Urol. doi:10.1097/JU.0000000000000813

Nandanan N and Autorino R. Editorial comment. J Urol.