IMPACT OF TUMOR 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 r elationship 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 c onsecutive patients with histologically verified TCC of the bladder re porting 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 stan dard 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, s tage, size and number or aggressiveness of metastases. Prognosis was n oticeably better if the patient did not smoke, as 27% of the non-smoke rs and 40% of the smokers had died during the first 10 years after dia gnosis. Survival was also better in patients with low grade (I, II), n on-invasive (Ta/T1) and small (less than or equal to 3 cm) tumours. Co nclusion In addition to the well-known prognostic factors (histologica l grade and stage of the tumour), smoking is a risk factor for bladder cancer and also has an impact on prognosis, leading to higher mortali ty from the disease in the longer term.