Sato Nobuaki, Shiota Masaki, Shiga Ken-Ichiro, Takeuchi Ario, Inokuchi Junichi, Tatsugami Katsunori, Yokomizo Akira, Koga Hirofumi, Yamaguchi Akito, Naito Seiji, Eto Masatoshi
Division of Urology, Harasanshin Hospital, Fukuoka.
Department of Urology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Jpn J Clin Oncol. 2017 May 1;47(5):453-457. doi: 10.1093/jjco/hyx013.
To analyze the association between smoking and oncological outcome after radical prostatectomy in patients with prostate cancer.
This study included men who underwent radical prostatectomy between 2003 and 2013. The association of clinicopathological factors with smoking status and the prognostic significance of clinicopathological factors and smoking status on biochemical recurrence (BCR) were evaluated.
Of the 1165 included patients, 226 (19.4%) were current smokers and 939 (80.6%) were nonsmokers. The median observation period was 39 months (interquartile range, 15-75 months). Current smokers were younger than nonsmokers and had higher PSA levels, higher biopsy and pathological Gleason scores, and more frequent lymph-node involvement than nonsmokers. Pathological Gleason score, extracapsular extension, seminal vesicle invasion, positive surgical margin, lymph-node involvement, and current smoking (hazard ratio [95% confidence interval]; 1.31 [1.00-1.72], P = 0.046) were identified as significant risk factors of BCR on univariate analysis. However, smoking status was not an independent predictive marker on multivariate analysis.
Current smokers had adverse clinicopathological characteristics including high PSA level, high Gleason score, and lymph node involvement, suggesting that smoking promoted the progression of prostate cancer.
分析前列腺癌患者根治性前列腺切除术后吸烟与肿瘤学结局之间的关联。
本研究纳入了2003年至2013年间接受根治性前列腺切除术的男性患者。评估临床病理因素与吸烟状况之间的关联,以及临床病理因素和吸烟状况对生化复发(BCR)的预后意义。
在纳入的1165例患者中,226例(19.4%)为当前吸烟者,939例(80.6%)为非吸烟者。中位观察期为39个月(四分位间距,15 - 75个月)。当前吸烟者比非吸烟者更年轻,前列腺特异性抗原(PSA)水平更高,活检和病理Gleason评分更高,淋巴结受累情况更常见。在单因素分析中,病理Gleason评分、包膜外侵犯、精囊侵犯、手术切缘阳性、淋巴结受累和当前吸烟(风险比[95%置信区间];1.31[1.00 - 1.72],P = 0.046)被确定为BCR的显著危险因素。然而,在多因素分析中,吸烟状况不是独立的预测指标。
当前吸烟者具有不良的临床病理特征,包括高PSA水平、高Gleason评分和淋巴结受累,提示吸烟促进了前列腺癌的进展。