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Int J Urol. 2015 Jul;22(7):658-62. doi: 10.1111/iju.12773. Epub 2015 Apr 14.

Smoking is a predictor of adverse pathological features at radical prostatectomy: Results from the Shared Equal Access Regional Cancer Hospital database.

Author information

1
Duke University Medical Center, Durham, North Carolina, USA.
2
Durham Veterans Affairs Medical Center, Durham, North Carolina, USA.
3
University of California, Los Angeles School of Medicine, Los Angeles, California, USA.
4
University of California, San Diego, California, USA.
5
Medical College of Georgia, Georgia Regents University, Augusta, Georgia, USA.
6
Oregon Health and Sciences University, Portland, Oregon, USA.
7
University of California San Francisco, San Francisco, California, USA.

Abstract

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 5.3 g; 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.

KEYWORDS:

pathology; prostatectomy; prostatic neoplasms; risk; smoking

PMID:
25872110
DOI:
10.1111/iju.12773
[Indexed for MEDLINE]
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