Smoking and adverse outcomes at radical prostatectomy

Area of Science:

• Urology
• Oncology
• Epidemiology

Background:

• Conflicting results exist regarding smoking's impact on prostate cancer incidence and mortality.
• This study investigates smoking's effect on pathologic outcomes and biochemical recurrence in men undergoing radical prostatectomy.

Purpose of the Study:

• To determine the association between smoking and adverse pathologic features in prostatectomy specimens.
• To evaluate the relationship between smoking and biochemical recurrence after radical prostatectomy.

Main Methods:

• A cohort of 630 men who underwent radical prostatectomy (1989-2005) with detailed smoking histories were analyzed.
• Pathologic outcomes included cancer volume, high-grade cancer volume, margin status, and metastasis.
• Biochemical recurrence was defined as prostate-specific antigen (PSA) ≥ 0.1 ng/ml; univariate and multivariate analyses were performed.

Main Results:

• Smokers had significantly greater volumes of cancer and high-grade cancer compared to nonsmokers.
• Smoking independently predicted larger cancer volumes and higher-grade cancer.
• Heavy smokers showed a greater risk of biochemical recurrence, with smoking predicting approximately 1% increased risk per pack-year.

Conclusions:

• Smoking is associated with adverse pathologic findings and an elevated risk of biochemical recurrence post-prostatectomy.
• Smoking history may be a valuable factor for inclusion in prostate cancer risk assessment models.