TY - JOUR
T1 - Cigarette smoking is associated with an increased risk of biochemical disease recurrence, metastasis, castration-resistant prostate cancer, and mortality after radical prostatectomy
T2 - Results from the SEARCH database
AU - Moreira, Daniel M.
AU - Aronson, William J.
AU - Terris, Martha K.
AU - Kane, Christopher J.
AU - Amling, Christopher L.
AU - Cooperberg, Matthew R.
AU - Boffetta, Paolo
AU - Freedland, Stephen J.
PY - 2014/1/15
Y1 - 2014/1/15
N2 - BACKGROUND The current study was conducted to analyze the association between cigarette smoking and metastasis (the primary outcome) as well as time to biochemical disease recurrence (BCR), metastasis, castration-resistant prostate cancer (CRPC), and prostate cancer-specific and overall mortality (secondary outcomes) after radical prostatectomy among men from the Shared Equal Access Regional Cancer Hospital cohort. METHODS A retrospective analysis was performed of 1450 subjects for whom smoking status was available from preoperative notes. Analysis of baseline characteristics by smoking status was performed using the chi-square and rank sum tests. The association between smoking status and time to the event was analyzed using Kaplan-Meier plots, the log-rank test, and Cox and competing risk models. RESULTS A total of 549 men (33%) men were active smokers and 1121 (67%) were nonsmokers at the time of surgery. Current smokers were younger and had a lower body mass index, higher prostate-specific antigen level, and more extracapsular extension and seminal vesicle invasion (all P <.05). A total of 509 patients, 26 patients, 30 patients, 18 patients, and 217 patients, respectively, experienced BCR, metastasis, CRPC, prostate cancer-related death, and any-cause death over a median follow-up of 62 months, 75 months, 61 months, 78 months, and 78 months, respectively. After adjusting for preoperative features, active smoking was found to be associated with an increased risk of BCR (hazards ratio [HR], 1.25; P =.024), metastasis (HR, 2.64; P =.026), CRPC (HR, 2.62; P =.021), and overall mortality (HR, 2.14; P <.001). Similar results were noted after further adjustment for postoperative features, with the exception of BCR (HR, 1.10; P =.335), metastasis (HR, 2.51; P =.044), CRPC (HR, 2.67; P =.015), and death (HR, 2.03; P <.001). CONCLUSIONS Among patients undergoing radical prostatectomy, cigarette smoking was associated with an increased risk of metastasis. In addition, smoking was associated with a higher risk of BCR, CRPC, and overall mortality. If confirmed, these data suggest that smoking is a modifiable risk factor in patients with aggressive prostate cancer.
AB - BACKGROUND The current study was conducted to analyze the association between cigarette smoking and metastasis (the primary outcome) as well as time to biochemical disease recurrence (BCR), metastasis, castration-resistant prostate cancer (CRPC), and prostate cancer-specific and overall mortality (secondary outcomes) after radical prostatectomy among men from the Shared Equal Access Regional Cancer Hospital cohort. METHODS A retrospective analysis was performed of 1450 subjects for whom smoking status was available from preoperative notes. Analysis of baseline characteristics by smoking status was performed using the chi-square and rank sum tests. The association between smoking status and time to the event was analyzed using Kaplan-Meier plots, the log-rank test, and Cox and competing risk models. RESULTS A total of 549 men (33%) men were active smokers and 1121 (67%) were nonsmokers at the time of surgery. Current smokers were younger and had a lower body mass index, higher prostate-specific antigen level, and more extracapsular extension and seminal vesicle invasion (all P <.05). A total of 509 patients, 26 patients, 30 patients, 18 patients, and 217 patients, respectively, experienced BCR, metastasis, CRPC, prostate cancer-related death, and any-cause death over a median follow-up of 62 months, 75 months, 61 months, 78 months, and 78 months, respectively. After adjusting for preoperative features, active smoking was found to be associated with an increased risk of BCR (hazards ratio [HR], 1.25; P =.024), metastasis (HR, 2.64; P =.026), CRPC (HR, 2.62; P =.021), and overall mortality (HR, 2.14; P <.001). Similar results were noted after further adjustment for postoperative features, with the exception of BCR (HR, 1.10; P =.335), metastasis (HR, 2.51; P =.044), CRPC (HR, 2.67; P =.015), and death (HR, 2.03; P <.001). CONCLUSIONS Among patients undergoing radical prostatectomy, cigarette smoking was associated with an increased risk of metastasis. In addition, smoking was associated with a higher risk of BCR, CRPC, and overall mortality. If confirmed, these data suggest that smoking is a modifiable risk factor in patients with aggressive prostate cancer.
KW - disease-free survival
KW - metastasis
KW - mortality
KW - prostate cancer
KW - prostate-specific antigen
KW - prostatectomy
KW - smoking
KW - tobacco
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U2 - 10.1002/cncr.28423
DO - 10.1002/cncr.28423
M3 - Article
C2 - 24127391
AN - SCOPUS:84891849654
SN - 0008-543X
VL - 120
SP - 197
EP - 204
JO - Cancer
JF - Cancer
IS - 2
ER -