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Oncologic Effect of Cumulative Smoking Exposure in Patients Treated With Salvage Radical Prostatectomy for Radiation-recurrent Prostate Cancer.
- Source :
-
Clinical genitourinary cancer [Clin Genitourin Cancer] 2018 Jun; Vol. 16 (3), pp. e619-e627. Date of Electronic Publication: 2017 Nov 10. - Publication Year :
- 2018
-
Abstract
- Introduction: The purpose of the present study was to investigate the association of smoking with biochemical recurrence (BCR) and metastasis in radiation-recurrent prostate cancer (PCa) patients undergoing salvage radical prostatectomy (SRP).<br />Patients and Methods: A total of 214 patients treated with SRP for radiation-recurrent PCa in 5 tertiary referral centers were included from January 2007 to December 2015. Kaplan-Meier analyses were used to assess the time to BCR and metastasis. Pre- and postoperative multivariable Cox proportional hazard regression models were fitted.<br />Results: Overall, 120 (56.1%), 49 (22.9%), and 45 (21%) patients were never, former, and current smokers, respectively. Low-, medium-, and high-cumulative smoking exposure was registered in 59.8%, 16.4%, and 23.8% of cases, respectively. Patients with high cumulative smoking exposure had a significantly greater rate of a pathologic Gleason score of ≥ 8 (P = .01) and extracapsular extension (P = .004). Smoking status, cumulative smoking exposure, intensity, and duration were significantly associated with BCR-free survival (P < .001 for all). Smoking status, cumulative smoking exposure, and smoking intensity were significantly associated with metastasis-free survival (P = .03 for all). High cumulative smoking exposure was independently associated with BCR in both pre- (hazard ratio, 2.23; P = .001) and postoperative (hazard ratio, 1.64; P = .04) multivariable models adjusted for the effects of established clinicopathologic features. Smoking cessation did not affect either BCR- or metastasis-free survival (P = .56 and P = .40, respectively).<br />Conclusion: High cumulative smoking exposure was associated with the biologic and clinical aggressiveness of PCa in patients treated with SRP for radiation-recurrent disease. Smoking is a modifiable risk factor that detrimentally affected the outcomes, even in patients with advanced PCa.<br /> (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Subjects :
- Aged
Humans
Kaplan-Meier Estimate
Male
Middle Aged
Neoplasm Recurrence, Local etiology
Neoplasm Recurrence, Local metabolism
Neoplasm Recurrence, Local radiotherapy
Prostate-Specific Antigen metabolism
Prostatectomy
Prostatic Neoplasms genetics
Prostatic Neoplasms metabolism
Prostatic Neoplasms radiotherapy
Risk Factors
Smoking adverse effects
Neoplasm Recurrence, Local surgery
Prostatic Neoplasms surgery
Salvage Therapy methods
Smoking epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1938-0682
- Volume :
- 16
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Clinical genitourinary cancer
- Publication Type :
- Academic Journal
- Accession number :
- 29239845
- Full Text :
- https://doi.org/10.1016/j.clgc.2017.10.015