Smoking duration and intensity associated with tumour aggressiveness in patients with urothelial carcinoma of the bladder: A correlation study

Abstract

Introduction:

Smoking is well recognized as the most important risk factor for the malignancy of bladder. Cigarette smoking is associated with a higher risk of bladder cancer. The influence of various parameters of smoking history was still unclear. The purpose of this study was to examine the relationship between smoking intensity and clinico-pathological features of bladder cancer.

Methods:

This was a retrospective study with non-probability consecutive sampling. All patients with urothelial cell carcinoma of the bladder in our hospital during 2009–2018 were included in the present study. The data were collected from medical records and then divided into three groups according to the intensity of smoking. The data were analysed, with statistical significance determined using Spearman’s rank correlation coefficient.

Result:

The data from a total of 260 urothelial bladder cancer patients were collected between 2009 and 2018. Based on statistical testing, it was found that there was a strong correlation between smoking intensity and local staging (T; r_s=0.827), with a greater tendency to develop a larger tumour growth as the smoking intensity increased. There was also a weak correlation between smoke intensity and grading (r_s=0.139). Meanwhile, no correlation was found between smoking intensity and the incidence of regional (N; r_s=0.119) and distant lymph node metastasis (M; r_s=0.239). Smoke status and intensity had a weak correlation with lesion (r_s=0.163 and 0.206, respectively). The type of cigarette and local staging had a small correlation (r_s=0.166).

Conclusion:

This study demonstrated that smoking intensity was significantly correlated only with primary tumour progression and grading, but not with the progression of regional and distant metastasis. There was a weak correlation between smoking status and intensity with the type of lesion, whether a solitary nodule or multiple nodules. This study also demonstrated a small correlation between the type of cigarette and local staging.

Level of evidence:

Keywords

Bladder cancer smoking intensity clinico-pathological metastasis

Get full access to this article

View all access options for this article.

References

Cumberbatch

Rota

Catto

JWF

, et al. The role of tobacco smoke in bladder and kidney carcinogenesis: a comparison of exposures and meta-analysis of incidence and mortality risks. Eur Urol 2016; 70: 458-466.

Kulkarni

Agarwal

Transperitoneal

vs.

extraperitoneal radical cystectomy for bladder cancer: a retrospective study. Int Braz J Urol 2018; 44: 296–303.

Pietzak

Mucksavage

Guzzo

, et al. Heavy cigarette smoking and aggresive bladder cancer at initial presentation. Urology 2015; 86: 968–973.

Burger

Catto

JWF

Dalbagni

, et al. Epidemiology and risk factors of urothelial bladder cancer. Eur Urol 2018; 63: 234–241.

Baris

Karagas

Verrill

, et al. A case-control study of smoking and bladder cancer risk: emergent patterns over time. J Natl Cancer Inst 2009; 101: 1553–1561.

Samanic

Kogevinas

Dosemeci

, et al. Smoking and bladder cancer in Spain: effects of tobacco type, timing, environmental tobacco smoke, and gender. Cancer Epidemiol Biomarkers Prev 2006; 15: 1348–1354.

Miyata

Kanda

Mitsunari

, et al. Heme oxygenase-1 expression is associated with tumor aggressiveness and outcomes in patients with bladder cancer: a correlation with smoking intensity. Transl Res 2014; 164: 468–476.

Aliramaji

Kaseean

Pasha

YRY

, et al. Age distribution types of bladder cancers and their relationship with opium consumption and smoking. Caspian J Intern Med 2015; 6: 82–86.

Freedman

Silverman

Hollenbeck

, et al. Association between smoking and risk of bladder cancer among men and women. JAMA 2011; 306: 737–745.

10.

Zeegers

MPA

Tan

FES

Dorant

, et al. The impact of characteristics of cigarette smoking on urinary tract cancer risk. Am Cancer Soc 2000; 89: 630–637.

11.

Van Osch

Jochems

Van Schooten

F-J

, et al. Quantified relations between exposure to tobacco smoking and bladder cancer risk: a meta-analysis of 89 observational studies. Int J Epidemiol 2016; 45: 857–870.

12.

Brennan

Bogillot

Cordier

, et al. Cigarette smoking and bladder cancer in men: a pooled analysis of 11 case-control studies. Int J Cancer 2000; 86: 289–294.

13.

Barbosa

Vermeulen

Aben

, et al. Smoking intensity and bladder cancer aggressiveness at diagnosis. PLoS One 2018; 13: e0194039.

14.

Sorahan

Lancashire

Sole

Urothelial cancer and cigarette smoking: findings from a regional case-controlled study. Br J Urol 1994; 74: 753–756.

15.

D’Avanzo

Negri

Vecchia

CL.

Cigarette smoking and bladder cancer. Eur J Cancer 1990; 26: 714–718.