It is well known that smoking is a risk factor for many tumors, but in prostate cancer (PCa) there seems to be controversy, and even some studies have shown that current smoking status reduces the risk of PCa. Also PCa
Biochemical recurrence after radical surgery is also an important issue for PCa patients. So what is the relationship between smoking and biochemical recurrence? Recently, Rieken et al. from Weill Cornell Medical College explored the relationship between smoking and biochemical recurrence in patients with PCa.
Recently, Rieken et al. from Weill Cornell Medical College explored the correlation between biochemical recurrence in patients after radical resection and preoperative smoking status, cumulative smoking exposure, and time to quit smoking. The results found that smoking increased the risk of biochemical recurrence of PCa, although quitting for more than 10 years reduced this risk. The article was published in a recent issue of European Urology. The retrospective study included a total of 6538 patients from 2000 to 2011 who had undergone radical resection for PCa (negative for lymph node metastases) and were not treated with neoadjuvant chemotherapy. Study metrics included clinicopathologic and smoking-related variables such as smoking status, number of cigarettes smoked per day (CPD), duration, and time to quit. The primary endpoint was the occurrence of biochemical relapse, i.e., two consecutive follow-up PSA > 0.2
ng/ml. The analysis showed that of 6538 patients, the number of never, former and current smokers was 2238 (34%), 2086 (32%) and
2214 (34%), and the patients were divided into three groups in this way. The median follow-up time without biochemical relapse was 28 months. In the three groups, Gleason
There were no significant differences in Gleason score, extra-adrenal bursal infiltration, seminal vesicle infiltration, and positive surgical margins. Five-year biochemical recurrence-free survival rates were 90%, 84%, and 83% in the three groups, respectively. The risk of biochemical recurrence of PCa was higher in former and current smokers compared to non-smokers. However, quitting smoking for 10 years or more reduced the risk of biochemical recurrence.
The risk of biochemical recurrence was reduced by quitting smoking for more than 10 years. In addition, multivariate analysis found no significant correlation between cumulative smoking exposure and risk of biochemical recurrence. The above results suggest that smoking status is strongly associated with biochemical recurrence after PCa radical surgery, with the risk of biochemical recurrence almost twice as high in former and current smokers as in nonsmokers. When smoking cessation was achieved for 10
The adverse effects of smoking on biochemical recurrence appeared to be mitigated when smoking was stopped for more than 10 years. This is a wake-up call for smoking patients that smokers need to be fully aware of the impact of smoking on PCa prognosis and for physicians to take a broader role in the health management of the smoking population.