MADRID, SPAIN (UroToday.com) - The purpose of this study was to see the association of pretreatment smoking status, cumulative exposure, and time since quitting smoking on the risk of biochemical recurrence in patients with clinically localized prostate cancer treated with radical prostatectomy.
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A total of 7 191 patients treated with radical prostatectomy between 2000 and 2011 were identified. Clinicopathologic variables, in addition to smoking history, were collected. Univariate and multivariate analysis was then performed to see the association of smoking with risk of biochemical relapse.
Of all patients, 34.9%, 31.6%, and 33.5% were never, former, and current smokers, respectively. Current smokers had a higher percentage of biopsy and prostatectomy specimens with Gleason score ≥ 8 (p < 0.0001) and more frequent seminal vesicle invasion (p < 0.0001) compared to former or never-smokers. With median follow-up of 28 months, former smokers and current smokers were associated with 2.03 (95% CI 1.63-2.53) and 2.26 (95% CI 1.83-2.80) increased risk of biochemical relapse, respectively, compared to non-smokers. Smoking cessation ≥ 10 years decreased the risk of biochemical relapse (HR 1.20, 95% CI 0.86-1.68), whereas smoking cessation ≤ 4 years (HR 2.19, 95% CI 1.70-2.81) and 5-9 years (HR 2.39, 95% CI 1.79-3.17) were associated with increased risk compared to non-smokers. No significant association between cumulative exposure and risk of biochemical relapse could be detected.
This study highlights the association between smoking and increased risk of biochemical relapse after radical prostatectomy. This risk is present even up to 10 years following smoking cessation. Smokers need to be counseled regarding the detrimental effects of smoking on prostate cancer outcome.
Presented by Rieken M.,1 Kluth L.,2 Fajkovic H.,3 Karakiewicz P.,4 Lotan Y.,5 Seitz C.,3 Briganti A.,6 Rouprêt M.,7 Loidl W.,8 Lee R.,9 Trinh Q-D.,10 Nyirady P.,11 Bachmann A.,1 Pourmand G-R.,12 and Shariat S.F.3 at the 30th Annual European Association of Urology (EAU) Congress - March 20 - 24, 2015 - IFEMA - Feria de Madrid - Madrid, Spain
1University Hospital Basel, Dept. of Urology, Basel, 2University Medical-Center Hamburg-Eppendorf, Dept. of Urology, Hamburg, 3Medical University of Vienna, Dept. of Urology, Vienna, 4University of Montreal, Dept. of Urology, Montreal, 5University of Texas Southwestern Medical Center, Dept. of Urology, Dallas, 6San Raffaele Scientific Institute, Urological Research Institute, Milan, 7AP-HP, Hopital Pitié-Salpétrière, Dept. of Urology, Paris, 8Krankenhaus Barmherzige Schwestern, Prostate Cancer Center, Linz, 9Weill Cornell Medical College, New York Presbyterian Hospital, Dept. of Urology, New York, 10Brigham and Women's Hospital, Dana-Farber Cancer Institute, Dept. of Urology, Boston, 11Semmelweis University, Dept. of Urology, Budapest, 12Tehran University of Medical Sciences, Dept. of Urology, Tehran
Reported by Mohammed Haseebuddin, MD, medical writer for UroToday.com