Smoking and prostate cancer survival and recurrence.
Smoking and prostate cancer survival and recurrence.
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DOI：
10.1001/jama.2011.879
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发表时间：
2011-06-22
影响因子：
120.7
通讯作者：
Giovannucci, Edward
中科院分区：
文献类型：
--
作者：
Kenfield, Stacey A.;Stampfer, Meir J.;Chan, June M.;Giovannucci, Edward
关于吸烟与前列腺癌患者的前列腺癌死亡率或复发的关系的研究有限，很少有前列腺癌特异性的结果。评估吸烟和戒烟与前列腺癌患者的总体、前列腺癌特异性、心血管疾病死亡率和生化复发的关系。在卫生专业人员随访研究中，对1986-2006年间被诊断为前列腺癌的5366名男性进行了前瞻性观察研究。由PSA升高定义的总体、前列腺癌特异性、心血管疾病死亡率和生化复发的风险比(HR)。我们记录了1630例死亡，其中524例(32%)死于前列腺癌，416例(26%)死于心血管疾病，878例生化复发。从不吸烟者与现在吸烟者的前列腺癌特定死亡率的绝对粗略比率分别为9.6/1000人年和15.3/1000人年；对于全因死亡率，相应的比率分别为27.3/1000人年和53.0/1000人年。在多变量分析中，与从不吸烟的人相比，现在吸烟的人前列腺癌死亡率(HR，1.61；95%可信区间[CI]，1.11-2.32)以及在临床分期T1-T3的男性中：HR，1.80；95%CI，1.04-3.12)，生化复发(HR，1.61；95%CI，1.16-2.22)，总死亡率(HR，2.28；95%CI，1.87-2.80)和心血管疾病死亡率(HR，2.13；95%可信区间为1.39-3.26)。在调整了吸烟与前列腺癌复发和生存关系的临床分期和分级后，当前吸烟的估计如下：前列腺癌死亡率(HR，1.38；95%CI，0.94-2.03；HR，1.41；95%CI，0.80-2.49)；生化复发(HR，1.47；95%CI，1.06-2.04)。吸烟年数越多，前列腺癌死亡率显著增加，但与生化复发风险无关：与从不吸烟者相比，现在吸烟40年以上的吸烟者：前列腺癌死亡率(HR，1.82；95%CI，1.03-3.20；生化复发，HR，1.48；95%CI，0.88-2.48)。与现在的吸烟者相比，戒烟10年或以上，或戒烟10年以下但吸烟少于20包的人的前列腺癌死亡风险与从不吸烟的人相似：曾经吸烟者，戒烟10年以上(HR，0.60；95%CI，0.42-0.87)；戒烟10年和20年(HR，0.64；95%CI，0.28-1.45)；从不吸烟(HR，0.61；95%CI，0.42-0.88)。前列腺癌确诊时吸烟与总死亡率和心血管疾病死亡率以及前列腺癌特有的死亡率和复发有关。戒烟10年的人有前列腺癌特有的死亡风险，与从不吸烟的人相似。
Studies of smoking in relation to prostate cancer mortality or recurrence in prostate cancer patients are limited, with few prostate cancer-specific outcomes. To assess the relation of cigarette smoking and smoking cessation with overall, prostate cancer-specific, and CVD mortality and biochemical recurrence among men with prostate cancer. Prospective observational study of 5 366 men diagnosed with prostate cancer between 1986–2006 in the Health Professionals Follow-Up Study. Hazard ratios (HRs) for overall, prostate cancer-specific, and CVD mortality, and biochemical recurrence, defined by PSA rise. We documented 1,630 deaths, 524 (32%) due to prostate cancer and 416 (26%) due to CVD, and 878 biochemical recurrences. The absolute crude rates for prostate cancer-specific death for never smokers vs. current smokers were 9.6 vs. 15.3 per 1,000 person-years; for all-cause mortality the corresponding rates were 27.3 and 53.0 per 1,000 person-years. In multivariable analysis, compared with never smokers, current smokers had an increased risk of prostate cancer mortality (HR, 1.61; 95% confidence interval [CI], 1.11–2.32 and among men with clinical stage T1–T3: HR, 1.80; 95% CI, 1.04–3.12), biochemical recurrence (HR, 1.61; 95% CI, 1.16–2.22), total mortality (HR, 2.28; 95% CI, 1.87–2.80), and CVD mortality (HR, 2.13; 95% CI, 1.39–3.26). After adjusting for clinical stage and grade which are likely intermediates of the relation of smoking with prostate cancer recurrence and survival, the estimates for current smoking were as follows: prostate cancer mortality (HR, 1.38; 95% CI, 0.94–2.03 and HR, 1.41; 95% CI, 0.80–2.49); biochemical recurrence (HR, 1.47; 95% CI, 1.06–2.04). A greater number of pack-years was associated with a significantly increased risk of prostate cancer mortality but not biochemical recurrence: for current smokers of 40+ pack-years compared to never smokers: prostate cancer mortality (HR, 1.82; 95% CI, 1.03–3.20; biochemical recurrence (HR, 1.48; 95% CI, 0.88–2.48). Compared to current smokers, those who had quit smoking for 10 or more years, or who had quit for less than 10 years but smoked less than 20 pack-years, had prostate cancer mortality risks similar to never smokers: former smoker, quit 10+ years (HR, 0.60; 95% CI, 0.42–0.87); quit <10 years and <20 pack-years (HR, 0.64; 95% CI, 0.28–1.45); never smoker (HR, 0.61; 95% CI, 0.42–0.88). Smoking at the time of prostate cancer diagnosis is associated with increased overall and CVD mortality and prostate cancer-specific mortality and recurrence. 10-year quitters have prostate cancer-specific mortality risks similar to never smokers.
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影响因子：
6.6
作者：
DANIELL, HW
通讯作者：
DANIELL, HW
DOI：
10.1016/j.ijrobp.2006.03.027
发表时间：
2006-08-01
影响因子：
7
作者：
Kuban, Deborah A.;Levy, Larry B.;Horwitz, Eric M.
通讯作者：
Horwitz, Eric M.
影响因子：
2.6
作者：
Byrne, Margaret M.;Davila, Evelyn P.;Lee, David J.
通讯作者：
Lee, David J.
影响因子：
2.3
作者：
Chan, JM;Holick, CN;Giovannucci, EL
通讯作者：
Giovannucci, EL
影响因子：
6.6
作者：
Oefelein, MG;Resnick, MI
通讯作者：
Resnick, MI