Impact of Tumour Grade, Stage, Number and Size, and Smoking and Sex, on Survival in Patients with Transitional Cell Carcinoma of the Bladder

Objective: To evaluate the impact of the grade, stage number and size of the tumour and of smoking and sex of patient on survival, and the relationship between smoking and tumour grade, stage, number and size, and sex of patient in patients with transitional cell carcinoma (TCC) of the urinary bladder.

Patients And Methods: The study comprised 252 consecutive patients with histologically verified TCC of the bladder reporting to Oulu University Central Hospital between 1978 and 1986. The average duration of follow-up was 6.7 years. The association between smoking and other covariates was analysed by cross-tabulation and standard chi-squared analyses. The Kaplan-Meier method was used to obtain estimated survival curves and significant differences determined using log rank statistics.

Results: Smoking had no impact on tumour grade, stage, size and number or aggressiveness of metastases. Prognosis was noticeably better if the patient did not smoke, as 27% of the non-smokers and 40% of the smokers had died during the first 10 years after diagnosis. Survival was also better in patients with low grade (I, II), non-invasive (Ta/T1) and small (< or = 3 cm) tumours.

Conclusion: In addition to the well-known prognostic factors (histological grade and stage of the tumour), smoking is a risk factor for bladder cancer and also has an impact on prognosis, leading to higher mortality from the disease in the longer term.