TY - JOUR
T1 - Association of cigarette smoking with interval to biochemical recurrence after radical prostatectomy
T2 - Results from the SEARCH database
AU - Moreira, Daniel M.
AU - Antonelli, Jodi A.
AU - Presti, Joseph C.
AU - Aronson, William J.
AU - Terris, Martha K.
AU - Kane, Christopher J.
AU - Amling, Christopher L.
AU - Freedland, Stephen J.
N1 - Funding Information:
This study was supported by the Department of Veterans Affairs, National Institute of Health grant R01CA100938 (to W. J. Aronson), National Institutes of Health Specialized Programs of Research Excellence grant P50 CA92131-01A1 (to W. J. Aronson), the Georgia Cancer Coalition (to M. K. Terris), Department of Defense Prostate Cancer Research Program (to S. J. Freedland), and the American Urological Association Foundation/Astellas Rising Star in Urology Award (to S. J. Freedland).
PY - 2010/11
Y1 - 2010/11
N2 - Objectives: To analyze the association between cigarette smoking and biochemical recurrence (BCR) after radical prostatectomy among men from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort. Methods: We performed a retrospective analysis of 1267 subjects from the SEARCH cohort treated from 1998 to 2008 with smoking status available from the preoperative notes. A comparison of the baseline patient and disease characteristics between the current smokers and nonsmokers (past and never smokers combined) was performed using the chi-square and rank sum tests. The univariate and multivariate associations between smoking status and BCR-free survival were analyzed using Kaplan-Meier plots, the log-rank test, and Cox proportional hazard models. Results: Of the 1267 patients, 408 (32%) were active smokers and 859 (68%) were nonsmokers at surgery. The current smokers were younger (P <.001), more likely to be black (P <.001), and had a lower body mass index (P <.001), a greater percentage of positive biopsy cores (P = .039), a greater preoperative prostate-specific antigen level (P = .003), more extracapsular extension (P = .003) and seminal vesicle invasion (P = .029), and lower prostate volumes (P = .002). On univariate analysis, smokers had a risk of BCR similar to that of nonsmokers (hazard ratio 1.19, P = .129). On multivariate analysis, smoking was associated with an increased risk of BCR when adjusted for body mass index only (hazard ratio 1.37, P = .008). However, after adjustment for multiple preoperative characteristics, the association was attenuated and no longer statistically significant (hazard ratio 1.12, P = .325). After additional adjustment for postoperative features, such as tumor grade and stage, smoking was unrelated to the risk of BCR (hazard ratio 0.91, P = .502). Conclusions: Among patients undergoing radical prostatectomy in the SEARCH cohort, cigarette smoking was associated with slightly more advanced disease but a similar risk of BCR.
AB - Objectives: To analyze the association between cigarette smoking and biochemical recurrence (BCR) after radical prostatectomy among men from the Shared Equal Access Regional Cancer Hospital (SEARCH) cohort. Methods: We performed a retrospective analysis of 1267 subjects from the SEARCH cohort treated from 1998 to 2008 with smoking status available from the preoperative notes. A comparison of the baseline patient and disease characteristics between the current smokers and nonsmokers (past and never smokers combined) was performed using the chi-square and rank sum tests. The univariate and multivariate associations between smoking status and BCR-free survival were analyzed using Kaplan-Meier plots, the log-rank test, and Cox proportional hazard models. Results: Of the 1267 patients, 408 (32%) were active smokers and 859 (68%) were nonsmokers at surgery. The current smokers were younger (P <.001), more likely to be black (P <.001), and had a lower body mass index (P <.001), a greater percentage of positive biopsy cores (P = .039), a greater preoperative prostate-specific antigen level (P = .003), more extracapsular extension (P = .003) and seminal vesicle invasion (P = .029), and lower prostate volumes (P = .002). On univariate analysis, smokers had a risk of BCR similar to that of nonsmokers (hazard ratio 1.19, P = .129). On multivariate analysis, smoking was associated with an increased risk of BCR when adjusted for body mass index only (hazard ratio 1.37, P = .008). However, after adjustment for multiple preoperative characteristics, the association was attenuated and no longer statistically significant (hazard ratio 1.12, P = .325). After additional adjustment for postoperative features, such as tumor grade and stage, smoking was unrelated to the risk of BCR (hazard ratio 0.91, P = .502). Conclusions: Among patients undergoing radical prostatectomy in the SEARCH cohort, cigarette smoking was associated with slightly more advanced disease but a similar risk of BCR.
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U2 - 10.1016/j.urology.2010.01.066
DO - 10.1016/j.urology.2010.01.066
M3 - Article
C2 - 20381838
AN - SCOPUS:78149358198
SN - 0090-4295
VL - 76
SP - 1218
EP - 1223
JO - Urology
JF - Urology
IS - 5
ER -