Prognostic importance of tobacco use in men receiving definitive prostate brachytherapy
Abstract Purpose Several prominent publications have identified an overall association between tobacco use and an increased risk of disease recurrence and disease-specific mortality in prostate cancer patients. The authors explored whether tobacco use adversely impacts treatment outcomes in men trea...
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Published in | Brachytherapy Vol. 11; no. 6; pp. 446 - 451 |
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Main Authors | , , , , , , , |
Format | Journal Article |
Language | English |
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United States
Elsevier Inc
01.11.2012
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Abstract | Abstract Purpose Several prominent publications have identified an overall association between tobacco use and an increased risk of disease recurrence and disease-specific mortality in prostate cancer patients. The authors explored whether tobacco use adversely impacts treatment outcomes in men treated with permanent interstitial brachytherapy. Methods and Materials From April 1995 to August 2008, 2057 patients underwent brachytherapy by a single brachytherapist. Median follow-up was 7.5 years. The role of tobacco use as a prognostic factor for biochemical progression-free survival, cause-specific survival, and overall survival was investigated. Differences in survival between smokers and nonsmokers were compared using Kaplan–Meier curves and log-rank tests. Results Current smokers presented with a lower body mass index ( p < 0.001), smaller prostate size ( p = 0.003), younger age ( p < 0.001), higher prostate-specific antigen level ( p = 0.002), a trend toward higher percentage biopsy core involvement ( p = 0.08), higher incidence of perineural invasion ( p = 0.015), and higher risk disease ( p < 0.001) than former or nonsmokers. There was no difference in biochemical progression-free survival ( p = 0.30) or cause-specific survival ( p = 0.72) at 10 years for smokers compared with nonsmokers. On univariate and multivariate analysis, tobacco use was an adverse risk factor for overall survival ( p < 0.001). There was no association between smoking and any prostate cancer-specific outcome. Conclusions Smokers treated with brachytherapy have excellent outcomes and are at no higher risk of treatment failure than men who are nonsmokers. |
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AbstractList | Several prominent publications have identified an overall association between tobacco use and an increased risk of disease recurrence and disease-specific mortality in prostate cancer patients. The authors explored whether tobacco use adversely impacts treatment outcomes in men treated with permanent interstitial brachytherapy.
From April 1995 to August 2008, 2057 patients underwent brachytherapy by a single brachytherapist. Median follow-up was 7.5 years. The role of tobacco use as a prognostic factor for biochemical progression-free survival, cause-specific survival, and overall survival was investigated. Differences in survival between smokers and nonsmokers were compared using Kaplan-Meier curves and log-rank tests.
Current smokers presented with a lower body mass index (p<0.001), smaller prostate size (p=0.003), younger age (p<0.001), higher prostate-specific antigen level (p=0.002), a trend toward higher percentage biopsy core involvement (p=0.08), higher incidence of perineural invasion (p=0.015), and higher risk disease (p<0.001) than former or nonsmokers. There was no difference in biochemical progression-free survival (p=0.30) or cause-specific survival (p=0.72) at 10 years for smokers compared with nonsmokers. On univariate and multivariate analysis, tobacco use was an adverse risk factor for overall survival (p<0.001). There was no association between smoking and any prostate cancer-specific outcome.
Smokers treated with brachytherapy have excellent outcomes and are at no higher risk of treatment failure than men who are nonsmokers. Abstract Purpose Several prominent publications have identified an overall association between tobacco use and an increased risk of disease recurrence and disease-specific mortality in prostate cancer patients. The authors explored whether tobacco use adversely impacts treatment outcomes in men treated with permanent interstitial brachytherapy. Methods and Materials From April 1995 to August 2008, 2057 patients underwent brachytherapy by a single brachytherapist. Median follow-up was 7.5 years. The role of tobacco use as a prognostic factor for biochemical progression-free survival, cause-specific survival, and overall survival was investigated. Differences in survival between smokers and nonsmokers were compared using Kaplan–Meier curves and log-rank tests. Results Current smokers presented with a lower body mass index ( p < 0.001), smaller prostate size ( p = 0.003), younger age ( p < 0.001), higher prostate-specific antigen level ( p = 0.002), a trend toward higher percentage biopsy core involvement ( p = 0.08), higher incidence of perineural invasion ( p = 0.015), and higher risk disease ( p < 0.001) than former or nonsmokers. There was no difference in biochemical progression-free survival ( p = 0.30) or cause-specific survival ( p = 0.72) at 10 years for smokers compared with nonsmokers. On univariate and multivariate analysis, tobacco use was an adverse risk factor for overall survival ( p < 0.001). There was no association between smoking and any prostate cancer-specific outcome. Conclusions Smokers treated with brachytherapy have excellent outcomes and are at no higher risk of treatment failure than men who are nonsmokers. PURPOSESeveral prominent publications have identified an overall association between tobacco use and an increased risk of disease recurrence and disease-specific mortality in prostate cancer patients. The authors explored whether tobacco use adversely impacts treatment outcomes in men treated with permanent interstitial brachytherapy.METHODS AND MATERIALSFrom April 1995 to August 2008, 2057 patients underwent brachytherapy by a single brachytherapist. Median follow-up was 7.5 years. The role of tobacco use as a prognostic factor for biochemical progression-free survival, cause-specific survival, and overall survival was investigated. Differences in survival between smokers and nonsmokers were compared using Kaplan-Meier curves and log-rank tests.RESULTSCurrent smokers presented with a lower body mass index (p<0.001), smaller prostate size (p=0.003), younger age (p<0.001), higher prostate-specific antigen level (p=0.002), a trend toward higher percentage biopsy core involvement (p=0.08), higher incidence of perineural invasion (p=0.015), and higher risk disease (p<0.001) than former or nonsmokers. There was no difference in biochemical progression-free survival (p=0.30) or cause-specific survival (p=0.72) at 10 years for smokers compared with nonsmokers. On univariate and multivariate analysis, tobacco use was an adverse risk factor for overall survival (p<0.001). There was no association between smoking and any prostate cancer-specific outcome.CONCLUSIONSSmokers treated with brachytherapy have excellent outcomes and are at no higher risk of treatment failure than men who are nonsmokers. |
Author | Butler, Wayne M Galbreath, Robert W Bennett, Abbey Merrick, Gregory S Adamovich, Edward Taira, Al V Lief, Jonathan H Wallner, Kent E |
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Cites_doi | 10.1007/s10552-009-9387-y 10.1016/j.ijrobp.2003.08.021 10.1093/oxfordjournals.aje.a009129 10.1093/jnci/djr124 10.1097/01.ju.0000125123.46733.93 10.1093/oxfordjournals.aje.a008663 10.1016/S0022-5347(05)63945-6 10.1001/jama.2011.879 10.1097/01.ju.0000118292.25214.a4 10.1002/1097-0215(20000520)89:3<259::AID-IJC8>3.0.CO;2-F 10.1007/s10552-007-9066-9 10.1016/j.urology.2010.01.066 10.1002/(SICI)1097-0215(19960917)67:6<764::AID-IJC3>3.0.CO;2-P 10.1016/j.ijrobp.2006.03.027 10.1111/j.1464-410X.2006.06656.x 10.1016/0360-3016(92)91059-V 10.1200/JCO.2003.05.110 |
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Keywords | Biochemical progression-free survival Overall survival Prostate cancer-specific survival Prostate cancer Smoking |
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Snippet | Abstract Purpose Several prominent publications have identified an overall association between tobacco use and an increased risk of disease recurrence and... Several prominent publications have identified an overall association between tobacco use and an increased risk of disease recurrence and disease-specific... PURPOSESeveral prominent publications have identified an overall association between tobacco use and an increased risk of disease recurrence and... |
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SubjectTerms | Aged Biochemical progression-free survival Brachytherapy - mortality Comorbidity Hematology, Oncology and Palliative Medicine Humans Incidence Male Middle Aged Neoplasm Recurrence, Local - mortality Neoplasm Recurrence, Local - prevention & control Overall survival Prognosis Prostate cancer Prostate cancer-specific survival Prostatic Neoplasms - mortality Prostatic Neoplasms - radiotherapy Radiology Risk Factors Smoking Smoking - mortality Survival Analysis Survival Rate Treatment Outcome United States - epidemiology |
Title | Prognostic importance of tobacco use in men receiving definitive prostate brachytherapy |
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