MP21-07 SELECTION EFFECTS MAY EXPLAIN SMOKING-RELATED OUTCOME DIFFERENCES AFTER RADICAL CYSTECTOMY

Abstract

You have accessJournal of UrologyBladder Cancer: Invasive I1 Apr 2017MP21-07 SELECTION EFFECTS MAY EXPLAIN SMOKING-RELATED OUTCOME DIFFERENCES AFTER RADICAL CYSTECTOMY Michael Froehner, Rainer Koch, Matthias Hübler, Ulrike Heberling, Vladimir Novotny, Stefan Zastrow, and Manfred P. Wirth Michael FroehnerMichael Froehner More articles by this author , Rainer KochRainer Koch More articles by this author , Matthias HüblerMatthias Hübler More articles by this author , Ulrike HeberlingUlrike Heberling More articles by this author , Vladimir NovotnyVladimir Novotny More articles by this author , Stefan ZastrowStefan Zastrow More articles by this author , and Manfred P. WirthManfred P. Wirth More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2017.02.3269AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES The impact of smoking on mortality in patients with bladder cancer is subject to controversies. METHODS We investigated 1000 patients who consecutively underwent radical cystectomy between 1993 and 2013. Proportional hazard models for competing risks were used to study combined effects of variables on bladder cancer and competing mortality. RESULTS The median follow-up in the survivors was 6.6 years; 331 patients had died from bladder cancer, 178 from non-cancer or unknown (n=6) causes and 54 from a second cancer. Compared with non-smokers, current smokers were more frequently male (35.7% versus 12.0%, p<0.0001), younger (63.5 versus 70.5 years, p<0.0001), had a lower body mass index (26.2 versus 27.1 kg/m2, p<0.0001) and suffered less frequently from cardiac insufficiency (12.7% versus 19.3%, p=0.0129). In current smokers there was a trend towards lower bladder cancer and higher competing mortality compared with non-smokers. In the multivariable analysis, current smoking was no predictor of bladder cancer mortality (hazard ratio, HR, in the full model 0.76, p=0.0687) but of competing mortality (HR in the optimal model 1.62, p=0.0044). CONCLUSIONS This study did not confirm adverse bladder cancer-related outcome in current smokers after radical cystectomy. With a younger mean age and a male predominance, current smokers showed a trend towards lower bladder cancer mortality that was eventually neutralized by increased competing mortality illustrating that selection effects may explain some smoking-related outcome differences after radical cystectomy. © 2017FiguresReferencesRelatedDetails Volume 197Issue 4SApril 2017Page: e250 Advertisement Copyright & Permissions© 2017MetricsAuthor Information Michael Froehner More articles by this author Rainer Koch More articles by this author Matthias Hübler More articles by this author Ulrike Heberling More articles by this author Vladimir Novotny More articles by this author Stefan Zastrow More articles by this author Manfred P. Wirth More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...