San Diego, CA USA (UroToday.com) Smoking is one of the most modifiable behaviors that negatively impacts prostate cancer treatment and prevention. To determine the effect of smoking on 30-day morbidity, Dr. David Byun and colleagues conducted a secondary data analysis of patients undergoing malignancy-related prostatectomy.
Utilizing the 2005 – 2013 American College of Surgeons National Surgical Quality Improvement Program (NSQIP), 22,802 patients undergoing malignancy-related prostatectomy were identified and stratified into current smokers (12.3%), former smokers (8.2%), and never smokers (79.5%). A multivariate analysis controlled for smoking status, demographic factors and preoperative comorbidity.
As compared to former and never smokers, current smokers experienced a higher rate of total complications (p=0.05) and unplanned intubation events (p<0.001). Subsequently, multivariate analysis established current smoking status as an independent predictor of both aforementioned complication rates (total OR 1.27, 95% CI: 1.06 to 1.53, p=0.011; unplanned intubation OR 5.87, 95% CI: 2.18 to 15.8, p<0.001).
Interestingly, the same conclusions could not be made about former smoking status: total complications, unplanned intubation events and post-operative pneumonia were not found to be statistically associated with smoking beyond 12 months pre-operation.
In general, complications occur following ~5% of radical prostatectomies. Smoking status not only increases the risk for postoerative complications following radical prostatectomy, but is an independent predictor of total complications and unplanned intubation within 30 days. As recognized by the researchers, this study cannot directly pinpoint the timepoint at which the benefits of smoking cessation are incurred. However, within a context of active surveillance, clinicians could greatly benefit their patients with early counseling.
Presented By: Nick Donin, MD
Written By: Linda Huynh; Biomedical Research Student, Department of Urology, University of California, Irvine at the 2016 AUA Annual Meeting - May 6 - 10, 2016 – San Diego, California, USA