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El tabaquismo y el cáncer de próstata: supervivencia y recurrencia
Stacey A Kenfield1, Meir J Stampfer, June M Chan
1Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA. skenfiel@hsph.harvard.edu
JAMA
|June 23, 2011
Resumen
Fumar en el momento del diagnóstico aumenta la mortalidad por cáncer de próstata y el riesgo de recurrencia. Dejar de fumar durante 10 años o más reduce significativamente el riesgo de muerte por cáncer de próstata, similar a los que nunca han fumado.
Área de la Ciencia:
- Oncología Oncología.
- Epidemiología La epidemiología.
- Salud Pública La salud pública.
Sus antecedentes:
- Existen estudios limitados sobre el impacto del tabaquismo en la mortalidad y la recurrencia del cáncer de próstata.
- Pocos estudios se centran en los resultados específicos del cáncer de próstata relacionados con el tabaquismo.
Objetivo del estudio:
- Evaluar la asociación entre fumar cigarrillos y dejar de fumar con la mortalidad (en general, específica del cáncer de próstata, enfermedad cardiovascular) y la recurrencia bioquímica en pacientes con cáncer de próstata.
Principales métodos:
- Estudio observacional prospectivo en el que participaron 5366 hombres diagnosticados con cáncer de próstata (1986-2006).
- Se calcularon los ratios de riesgo (HR) para la mortalidad y la recurrencia bioquímica (definidos por los niveles de PSA).
Principales resultados:
- Los fumadores actuales se enfrentaban a mayores riesgos de mortalidad por cáncer de próstata (HR 1.61), recurrencia bioquímica (HR 1.61), mortalidad total (HR 2.28), y mortalidad por ECV (HR 2.13) en comparación con los que nunca han fumado.
- Fumar más de 40 paquetes por año aumentó significativamente el riesgo de mortalidad por cáncer de próstata (HR 1.82).
- Dejar de fumar durante más de 10 años redujo el riesgo de mortalidad por cáncer de próstata a niveles similares a los de los que nunca han fumado (HR 0,60).
Conclusiones:
- Fumar en el momento del diagnóstico está relacionado con un aumento de la mortalidad y la recurrencia en pacientes con cáncer de próstata.
- Dejar de fumar durante al menos 10 años mitiga el riesgo de mortalidad específico del cáncer de próstata, llevándolo a niveles comparables a los de los que nunca han fumado.
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