TY - JOUR
T1 - Smoking is a predictor of adverse pathological features at radical prostatectomy
T2 - Results from the Shared Equal Access Regional Cancer Hospital database
AU - Zapata, Daniel F.
AU - Howard, Lauren E.
AU - Aronson, William J.
AU - Kane, Christopher J.
AU - Terris, Martha K.
AU - Amling, Christopher L.
AU - Cooperberg, Matthew R.
AU - Freedland, Stephen J.
N1 - Publisher Copyright:
© 2015 The Japanese Urological Association.
PY - 2015/7/1
Y1 - 2015/7/1
N2 - Objective: To test the relationship of smoking and aggressive prostate cancer in men undergoing radical prostatectomy. Methods: A retrospective analysis of 2290 men who underwent radical prostatectomy from the Shared Equal Access Regional Cancer Hospital database from 2000 to 2013 was carried out. There were 1592 (70%) non-smokers and 698 (30%) smokers at radical prostatectomy. Logistic regression was used to examine whether smoking predicted Gleason score (≥4+3), margin status, extracapsular extension or seminal vesicle invasion. Linear regression was used to test the relationship between smoking and tumor volume. Results: Smokers were younger, more likely to be black, had lower body mass index, higher pathological Gleason score, more positive margins and extracapsular extension (all P<0.05) versus non-smokers. On crude analysis, smoking was associated with positive margins (odds ratio 1.32; P=0.003) and extracapsular extension (odds ratio 1.26; P=0.036). After adjusting for multiple clinical factors, smoking remained associated with a 19-35% increased risk of every adverse feature studied, though only the association with extracapsular extension reached significance. On multivariable analysis, a trend for smokers to have larger tumor volumes (geometric mean 5.8 vs 5.3g; P=0.062) was found. Conclusions: In patients undergoing radical prostatectomy, there seems to be a trend for smokers to have worse pathological features compared with non-/former smokers. If confirmed in future studies, smoking should be considered a modifiable risk factor for aggressive prostate cancer.
AB - Objective: To test the relationship of smoking and aggressive prostate cancer in men undergoing radical prostatectomy. Methods: A retrospective analysis of 2290 men who underwent radical prostatectomy from the Shared Equal Access Regional Cancer Hospital database from 2000 to 2013 was carried out. There were 1592 (70%) non-smokers and 698 (30%) smokers at radical prostatectomy. Logistic regression was used to examine whether smoking predicted Gleason score (≥4+3), margin status, extracapsular extension or seminal vesicle invasion. Linear regression was used to test the relationship between smoking and tumor volume. Results: Smokers were younger, more likely to be black, had lower body mass index, higher pathological Gleason score, more positive margins and extracapsular extension (all P<0.05) versus non-smokers. On crude analysis, smoking was associated with positive margins (odds ratio 1.32; P=0.003) and extracapsular extension (odds ratio 1.26; P=0.036). After adjusting for multiple clinical factors, smoking remained associated with a 19-35% increased risk of every adverse feature studied, though only the association with extracapsular extension reached significance. On multivariable analysis, a trend for smokers to have larger tumor volumes (geometric mean 5.8 vs 5.3g; P=0.062) was found. Conclusions: In patients undergoing radical prostatectomy, there seems to be a trend for smokers to have worse pathological features compared with non-/former smokers. If confirmed in future studies, smoking should be considered a modifiable risk factor for aggressive prostate cancer.
KW - Pathology
KW - Prostatectomy
KW - Prostatic neoplasms
KW - Risk
KW - Smoking
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U2 - 10.1111/iju.12773
DO - 10.1111/iju.12773
M3 - Article
C2 - 25872110
AN - SCOPUS:84937073697
SN - 0919-8172
VL - 22
SP - 658
EP - 662
JO - International Journal of Urology
JF - International Journal of Urology
IS - 7
ER -