Tobacco use and outcome in radical prostatectomy patients.
Cigarette smoking has been consistently associated with increased risk of overall mortality, but the importance of smoking for patients with prostate cancer (CaP) who are candidates for curative radical prostatectomy (RP) has received less attention. This retrospectively designed cohort study investigated the association of smoking history at RP with subsequent CaP treatment outcomes and overall mortality. A total of 1981 patients who underwent RP at Roswell Park Cancer Institute (RPCI) between 1993 and 2014 were studied. Smoking history was considered as a risk factor for overall mortality as well as for currently accepted CaP treatment outcomes (biochemical failure, treatment failure, distant metastasis, and disease-specific mortality). The associations of smoking status with these outcomes were tested by Cox proportional hazard analyses. A total of 153 (8%) patients died during follow-up. Current smoking at diagnosis was a statistically significant predictor of overall mortality after RP (current smokers vs. former and never smokers, hazards ratio 2.07, 95% confidence interval [CI]: 1.36-3.14). This association persisted for overall mortality at 3, 5, and 10 years (odds ratios 2.07 [95% CI: 1.36-3.15], 2.05 [95% CI: 1.35-3.12], and 1.8 [95% CI: 1.18-2.74], respectively). Smoking was not associated with biochemical failure, treatment failure, distant metastasis, or CaP-specific mortality, and the association of smoking with overall mortality did not appear to be functionally related to treatment or biochemical failure, or to distant metastasis. Smoking is a non-negligible risk factor for death among CaP patients who undergo RP; patients who smoke are far more likely to die of causes other than CaP.
Department of Biostatistics, University of Iowa, Iowa City, Iowa.|Department of Cancer Prevention, Roswell Park Cancer Institute, Buffalo, New York.|Department of Biostatistics, University at Buffalo, Buffalo, New York.
Alexandra
A
Curtis
Department of Cancer Prevention, Roswell Park Cancer Institute, Buffalo, New York.
Rochelle Payne
RP
Ondracek
Department of Urology, Roswell Park Cancer Institute, Buffalo, New York.|Center for Immunotherapy, Roswell Park Cancer Institute, Buffalo, New York.
Christine
C
Murekeyisoni
Department of Urology and Department of Cancer Genetics, Roswell Park Cancer Institute, Buffalo, New York.|Department of Urology, State University of New York at Buffalo, Buffalo, New York.
Eric
E
Kauffman
Department of Urology, Roswell Park Cancer Institute, Buffalo, New York.|Department of Urology, State University of New York at Buffalo, Buffalo, New York.
James
J
Mohler
Department of Cancer Prevention, Roswell Park Cancer Institute, Buffalo, New York.
James
http://orcid.org/0000-0001-8956-5945
J
Marshall
D015331:Cohort Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011468:Prostatectomy / Q000401:mortality*; D011471:Prostatic Neoplasms / Q000601:surgery*; D012189:Retrospective Studies; D064424:Tobacco Use / Q000009:adverse effects*; D016896:Treatment Outcome
Cancer; history; outcomes; prostate; smoking