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Kumar R, Matulewicz R, Mari A, Moschini M, Ghodoussipour S, Pradere B, Rink M, Autorino R, Desai MM, Gill I, Cacciamani GE. Impact of smoking on urologic cancers: a snapshot of current evidence. World J Urol 2023; 41:1473-1479. [PMID: 37093319 PMCID: PMC10241723 DOI: 10.1007/s00345-023-04406-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 04/06/2023] [Indexed: 04/25/2023] Open
Abstract
PURPOSE The purpose of this paper is to present evidence regarding the associations between smoking and the following urologic cancers: prostate, bladder, renal, and upper tract urothelial cancer (UTUC). METHODS This is a narrative review. PubMed was queried for evidence-based analyses and trials regarding the associations between smoking and prostate, bladder, renal, and UTUC tumors from inception to September 1, 2022. Emphasis was placed on articles referenced in national guidelines and protocols. RESULTS Prostate-multiple studies associate smoking with higher Gleason score, higher tumor stage, and extracapsular invasion. Though smoking has not yet been linked to tumorigenesis, there is evidence that it plays a role in biochemical recurrence and cancer-specific mortality. Bladder-smoking is strongly associated with bladder cancer, likely due to DNA damage from the release of carcinogenic compounds. Additionally, smoking has been linked to increased cancer-specific mortality and higher risk of tumor recurrence. Renal-smoking tobacco has been associated with tumorigenesis, higher tumor grade and stage, poorer mortality rates, and a greater risk of tumor recurrence. UTUC-tumorigenesis has been associated with smoking tobacco. Additionally, more advanced disease, higher stage, lymph node metastases, poorer survival outcomes, and tumor recurrence have been linked to smoking. CONCLUSION Smoking has been shown to significantly affect most urologic cancers and has been associated with more aggressive disease, poorer outcomes, and tumor recurrence. The role of smoking cessation is still unclear, but appears to provide some protective effect. Urologists have an opportunity to engage in primary prevention by encouraging cessation practices.
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Affiliation(s)
- Raj Kumar
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Richard Matulewicz
- Department of Surgery, Urology Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrea Mari
- Department of Urology, Careggi Hospital, University of Florence, Florence, Italy
| | - Marco Moschini
- Department of Urology, La Croix du Sud Hospital, 31130, Quint Fonsegrives, France
| | - Saum Ghodoussipour
- Bladder and Urothelial Cancer Program, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Michael Rink
- Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Riccardo Autorino
- Division of Urology, Department of Surgery, Virginia Commonwealth University, Richmond, VA, USA
| | - Mihir M Desai
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Inderbir Gill
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Giovanni E Cacciamani
- The Catherine and Joseph Aresty Department of Urology, USC Institute of Urology, Keck School of Medicine, University of Southern California, Los Angeles, USA.
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Quhal F, Rajwa P, Mori K, Laukhtina E, Grossmann NC, Schuettfort VM, König F, Aydh A, Motlagh RS, Katayama S, Mostafai H, Pradere B, Marra G, Gontero P, Mathieu R, Karakiewicz PI, Briganti A, Shariat SF, Heidenreich A. The role of lymph node dissection in salvage radical prostatectomy for patients with radiation recurrent prostate cancer. Prostate 2021; 81:765-771. [PMID: 34057227 PMCID: PMC8361975 DOI: 10.1002/pros.24173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 05/07/2021] [Accepted: 05/14/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To examine the effect of lymph node dissection on the outcomes of patients who underwent salvage radical prostatectomy (SRP). MATERIAL AND METHODS We retrospectively reviewed data from radiation-recurrent patients with prostate cancer (PCa) who underwent SRP from 2000-2016. None of the patients had clinical lymph node involvement before SRP. The effect of the number of removed lymph nodes (RLNs) and the number of positive lymph nodes (PLNs) on biochemical recurrence (BCR)-free survival, metastases free survival, and overall survival (OS) was tested in multivariable Cox regression analyses. RESULTS About 334 patients underwent SRP and pelvic lymph node dissection (PLND). Lymph node involvement was associated with increased risk of BCR (p < .001), metastasis (p < .001), and overall mortality (p = .006). In a multivariable Cox regression analysis, an increased number of RLNs significantly lowered the risk of BCR (hazard ratio [HR] 0.96, p = .01). In patients with positive lymph nodes, a higher number of RLNs and a lower number of PLNs were associated with improved freedom from BCR (HR 0.89, p = .001 and HR 1.34, p = .008, respectively). At a median follow-up of 23.9 months (interquartile range, 4.7-37.7), neither the number of RLNs nor the number of PLNs were associated with OS (p = .69 and p = .34, respectively). CONCLUSION Pathologic lymph node involvement increased the risk of BCR, metastasis and overall mortality in radiation-recurrent PCa patients undergoing SRP. The risk of BCR decreased steadily with a higher number of RLNs during SRP. Further research is needed to support this conclusion and develop a precise therapeutic adjuvant strategy based on the number of RLNs and PLNs.
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Affiliation(s)
- Fahad Quhal
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of UrologyKing Fahad Specialist HospitalDammamSaudi Arabia
| | - Pawel Rajwa
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of UrologyMedical University of SilesiaZabrzePoland
| | - Keiichiro Mori
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of UrologyThe Jikei University School of MedicineTokyoJapan
| | - Ekaterina Laukhtina
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Institute for Urology and Reproductive HealthSechenov UniversityMoscowRussia
| | - Nico C. Grossmann
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of UrologyUniversity Hospital ZurichZurichSwitzerland
| | - Victor M. Schuettfort
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of UrologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Frederik König
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of UrologyUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Abdulmajeed Aydh
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of UrologyKing Faisal Medical CityAbhaSaudi Arabia
| | - Reza S. Motlagh
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Men's Health and Reproductive Health Research Center, Shahid Beheshti University of Medical SciencesTehranIran
| | - Satoshi Katayama
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of UrologyOkayama University Graduate School of Medicine, Dentistry, and Pharmaceutical SciencesOkayamaJapan
| | - Hadi Mostafai
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Research Center for Evidence Based MedicineTabriz University of Medical SciencesTabrizIran
| | - Benjamin Pradere
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
| | - Giancarlo Marra
- Division of Urology, Department of Surgical SciencesSan Giovanni Battista HospitalUniversity of Studies of TorinoTurinItaly
| | - Paolo Gontero
- Division of Urology, Department of Surgical SciencesSan Giovanni Battista HospitalUniversity of Studies of TorinoTurinItaly
| | - Romain Mathieu
- Department of UrologyRennes University HospitalRennesFrance
| | - Pierre I. Karakiewicz
- Cancer Prognostics and Health Outcomes UnitUniversity of Montreal Health CentreMontrealCanada
| | - Alberto Briganti
- Department of UrologyVita Salute San Raffaele UniversityMilanItaly
| | - Shahrokh F. Shariat
- Institute for Urology and Reproductive HealthSechenov UniversityMoscowRussia
- Department of UrologyWeill Cornell Medical CollegeNew York CityNew YorkUSA
- Department of UrologyUniversity of Texas SouthwesternDallasTexasUSA
- Department of UrologySecond Faculty of MedicineCharles UniversityPragueCzech Republic
- Division of Urology, Department of Special SurgeryJordan University HospitalThe University of JordanAmmanJordan
| | - Axel Heidenreich
- Department of UrologyComprehensive Cancer CenterMedical University of ViennaViennaAustria
- Department of UrologyUniversity Hospital CologneCologneGermany
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Quhal F, Pradere B, Sari Motlagh R, Mori K, Laukhtina E, Aydh A, Mostafaei H, Lysenko I, Schuettfort VM, Stolzenbach F, Palumbo C, Heidenreich A, Briganti A, Karakiewicz PI, Chlosta P, Shariat SF. Prognostic value of preoperative albumin to globulin ratio in patients treated with salvage radical prostatectomy for radiation recurrent prostate cancer. Minerva Urol Nephrol 2020; 73:610-615. [PMID: 32993278 DOI: 10.23736/s2724-6051.20.03938-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Serum albumin-to-globulin ratio (AGR) has been shown to be associated with poor prognosis in different malignancies. In this study we aimed to evaluate the predictive value of preoperative AGR for oncological outcomes in patients with radiation recurrent prostate cancer (PCa) treated with salvage radical prostatectomy (SRP). METHODS A retrospective review of 214 consecutive patients with radiation recurrent PCa who underwent SRP at five referral centers. Levels of albumin and globulin were obtained before SRP and used to calculate the preoperative AGR level. The optimal cut off value of preoperative AGR was 1.4. Univariable and multivariable Cox regression analyses were performed. RESULTS Overall 89 (41.6%) patients had a low preoperative AGR. Low serum AGR was associated with biochemical recurrence (BCR) in univariable Cox regression analysis (HR 1.60, 95%CI 1.06-2.43, P=0.026). When adjusted for the effects of established preoperative and postoperative clinicopathologic confounders in different multivariable Cox regression models, this association did not retain its statistical significance. Moreover, preoperative AGR was not associated with metastasis free survival (P=0.21), overall survival (P=0.91) or cancer specific survival (P=0.61). CONCLUSIONS In patients with radiation recurrent PCa undergoing SRP, low preoperative AGR was associated with the risk of BCR only in univariable analysis. There was no association with metastasis or survival outcomes. Further studies are needed to evaluate this biomarker in the setting of primary PCa and to identify the patients most likely to benefit from a local therapy.
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Affiliation(s)
- Fahad Quhal
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Benjamin Pradere
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, University Hospital of Tours, Tours, France
| | - Reza Sari Motlagh
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Keiichiro Mori
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,School of Medicine, Department of Urology, The Jikei University, Tokyo, Japan
| | - Ekaterina Laukhtina
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Abdulmajeed Aydh
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,King Faisal Medical City, Abha, Saudi Arabia
| | - Hadi Mostafaei
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Research Center for Evidence Based Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ivan Lysenko
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Victor M Schuettfort
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria.,Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Stolzenbach
- Unit of Cancer Prognostics and Health Outcomes, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
| | - Carlotta Palumbo
- Unit of Cancer Prognostics and Health Outcomes, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
| | - Axel Heidenreich
- Department of Urology, University Hospital Cologne, Cologne, Germany
| | - Alberto Briganti
- Unit of Urology, Division of Oncology, URI, IRCCS San Raffaele Hospital, Milan, Italy
| | - Pierre I Karakiewicz
- Unit of Cancer Prognostics and Health Outcomes, Division of Urology, University of Montreal Health Center, Montreal, QC, Canada
| | - Piotr Chlosta
- Department of Urology, Jagiellonian University Medical College, Kraków, Poland
| | - Shahrokh F Shariat
- Department of Urology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria - .,Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia.,Department of Urology, Weill Cornell Medical College, New York, NY, USA.,Department of Urology, University of Texas Southwestern, Dallas, TX, USA.,Department of Urology, Second Faculty of Medicine, Charles University, Prague, Czech Republic.,Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan.,European Association of Urology Research Foundation, Arnhem, the Netherlands.,Karl Landsteiner Institute, Vienna, Austria
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