Does smoking cause prostate cancer recurrence?

Smoking is a risk factor for many tumors, but it seems to be controversial in prostate cancer (PCa). Some studies even show that current smoking status can reduce the risk of PCa. At the same time, biochemical recurrence after PCa radical surgery is also an important problem faced by PCa patients.

So, what is the relationship between smoking and biochemical recurrence?

Recently, Rieken and other scholars from Weill Cornell Medical College in the United States explored the correlation between biochemical recurrence in patients after radical resection of PCa and preoperative smoking status, cumulative smoking exposure, and time before smoking cessation.

The results showed that smoking can increase the risk of PCa biochemical recurrence, but quitting smoking for more than 10 years can reduce this risk. The article was published in the recent European Urology.

This retrospective study included 6538 patients who underwent radical resection of PCa (lymph node negative) from 2000 to 2011 and did not receive neoadjuvant chemotherapy.

The study indicators included clinical pathology and smoking-related variables such as smoking status, number of cigarettes smoked per day (CPD), duration and time to quit smoking, etc. The primary endpoint was the occurrence of biochemical recurrence, that is, PSA>0.2ng/ml in two consecutive follow-up visits.

The analysis results showed that among 6538 patients, the number of never, former and current smokers were 2238 (34%), 2086 (32%) and 2214 (34%), respectively, and the patients were divided into three groups based on this.

The median follow-up time without biochemical recurrence was 28 months. There were no significant differences in Gleason score, extracapsular invasion, seminal vesicle invasion, and positive surgical margin among the three groups of patients. The five-year biochemical recurrence-free survival rates of the three groups were 90%, 84%, and 83%, respectively.

Compared with non-smokers, patients who were past and current smokers had a higher risk of PCa biochemical recurrence. However, quitting smoking for more than 10 years can reduce the risk of biochemical recurrence. In addition, multivariate analysis found no significant association between cumulative smoking exposure and the risk of biochemical recurrence.

It is better to avoid it with one blow than to rise first and then fall.

The above results indicate that smoking status is closely associated with biochemical recurrence after PCa radical resection, and the risk of biochemical recurrence in patients with past and current smoking is almost twice that of non-smoking patients. The adverse effect of smoking on biochemical recurrence seems to be alleviated when smoking is quit for more than 10 years.

This is a wake-up call for smoking patients. Smokers need to fully realize the impact of smoking on PCa prognosis. Doctors also need to play a broader role in the health management of smokers.