The association between cigarette smoking and survival in patients with renal cell carcinoma is not well studied. We examined the impact of cigarette smoking on survival of patients with advanced renal cell carcinoma using the multi-institutional national database of the Japanese Urological Association.
From 340 Japanese institutions, 963 patients with renal cell carcinoma of clinical Stage 3 or higher were analyzed. Univariate analysis using the Kaplan-Meier method and multivariate Cox regression models with stepwise selection was used to evaluate overall and cause-specific survival.
Median duration of follow-up was 842 days, and overall and cancer death occurred in 392 (40.7%) and 351 (36.4%) patients, respectively. In multivariate analysis, smoking 20 or more cigarettes daily at diagnosis was associated with poorer overall and cancer-specific survival, especially in Stage 3. According to a Cox proportional hazards model, heavy cigarette smoking at diagnosis and the variables of underweight, fever symptoms, serum lactic dehydrogenase value, serum C-reactive protein value, serum creatinine value, Eastern Cooperative Oncology Group performance status, nephrectomy and clinical stage were significant (P < 0.05) for overall and cancer-specific survival.
We could compare the smoking status at diagnosis and the prognosis of renal cell carcinoma at national wide scale. Heavy active smoking was an independent prognostic factor for overall and cancer-specific survival in patients with advanced renal cell carcinoma, especially in Stage 3.
Japanese journal of clinical oncology. 2017 Nov 07 [Epub ahead of print]
Tomohiko Hara, Hiroyuki Fujimoto, Tsunenori Kondo, Nobuo Shinohara, Wataru Obara, Go Kimura, Haruki Kume, Norio Nonomura, Fumiya Hongo, Takayuki Sugiyama, Hiro-Omi Kanayama, Masayuki Takahashi, Tomoharu Fukumori, Masatoshi Eto, Cancer Registration Committee of the Japanese Urological Association
Working Group of the Kidney Cancer Registration Committee of the Japanese Urological Association.