Impact of smoking status on survival after cytoreductive nephrectomy for metastatic renal cell carcinoma

Harun Fajkovic, Shahrokh F. Shariat, Tobias Klatte, Mihai Dorin Vartolomei, Ilaria Lucca, Aurélie Mbeutcha, Morgan Rouprêt, Alberto Briganti, Pierre I. Karakiewicz, Vitaly Margulis, Michael Rink, Mesut Remzi, Christian Seitz, Karim Bensalah, Romain Mathieu

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Abstract

Objective: To assess the association of smoking status with standard clinicopathological features and overall survival (OS) in a large multi-institutional cohort of patients with metastatic renal cell carcinoma (mRCC) treated with cytoreductive nephrectomy (CNT). Methods: A total of 613 patients with mRCC treated with CNT in US and Europe institutions between 1990 and 2013 were included. Smoking history comprised smoking status, smoking duration in years, number of cigarettes per day and years since smoking cessation. Cumulative smoking exposure was categorized as light short term, heavy long term and moderate. Association between smoking history and OS was assessed by Cox regression logistic analysis. Results: One hundred and seventy-one patients (27.9 %) never smoked, 193 (31.5 %) were former smokers and 249 (40.6 %) were current smokers. Smoking status was associated with a higher number of metastases (p <0.001) and an abnormal preoperative corrected calcium level (p = 0.01). Median follow-up was 16 (IQR 7–24) months. Current smokers had a shorter OS than never and former smokers (log rank, p = 0.004). Smoking status was significantly associated with OS in univariable analysis (HR 1.45; 95 % CI 1.16–1.82; p <0.001), and in multivariable analysis that adjusted for established prognostic factors (HR 1.46; 95 % CI 1.16–1.84; p = 0.002). Daily consumption of more than 20 cigarettes, more than 20 years of smoking exposure and heavy long exposure were all independent prognosticators of worse OS. Conclusions: Current smoking and a higher cumulative smoking exposure are associated with a higher risk of death in patients with mRCC treated with CNT. Even at this stage, smoking negatively affects kidney cancer outcomes.

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalWorld Journal of Urology
DOIs
StateAccepted/In press - Feb 15 2016

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Nephrectomy
Renal Cell Carcinoma
Smoking
Survival
Tobacco Products
History
Kidney Neoplasms
Smoking Cessation
Regression Analysis
Neoplasm Metastasis
Calcium
Light

Keywords

  • Cytoreductive nephrectomy
  • Renal carcinoma
  • Smoking status
  • Survival

ASJC Scopus subject areas

  • Urology

Cite this

Fajkovic, H., Shariat, S. F., Klatte, T., Vartolomei, M. D., Lucca, I., Mbeutcha, A., ... Mathieu, R. (Accepted/In press). Impact of smoking status on survival after cytoreductive nephrectomy for metastatic renal cell carcinoma. World Journal of Urology, 1-9. https://doi.org/10.1007/s00345-016-1767-9

Impact of smoking status on survival after cytoreductive nephrectomy for metastatic renal cell carcinoma. / Fajkovic, Harun; Shariat, Shahrokh F.; Klatte, Tobias; Vartolomei, Mihai Dorin; Lucca, Ilaria; Mbeutcha, Aurélie; Rouprêt, Morgan; Briganti, Alberto; Karakiewicz, Pierre I.; Margulis, Vitaly; Rink, Michael; Remzi, Mesut; Seitz, Christian; Bensalah, Karim; Mathieu, Romain.

In: World Journal of Urology, 15.02.2016, p. 1-9.

Research output: Contribution to journalArticle

Fajkovic, H, Shariat, SF, Klatte, T, Vartolomei, MD, Lucca, I, Mbeutcha, A, Rouprêt, M, Briganti, A, Karakiewicz, PI, Margulis, V, Rink, M, Remzi, M, Seitz, C, Bensalah, K & Mathieu, R 2016, 'Impact of smoking status on survival after cytoreductive nephrectomy for metastatic renal cell carcinoma', World Journal of Urology, pp. 1-9. https://doi.org/10.1007/s00345-016-1767-9
Fajkovic, Harun ; Shariat, Shahrokh F. ; Klatte, Tobias ; Vartolomei, Mihai Dorin ; Lucca, Ilaria ; Mbeutcha, Aurélie ; Rouprêt, Morgan ; Briganti, Alberto ; Karakiewicz, Pierre I. ; Margulis, Vitaly ; Rink, Michael ; Remzi, Mesut ; Seitz, Christian ; Bensalah, Karim ; Mathieu, Romain. / Impact of smoking status on survival after cytoreductive nephrectomy for metastatic renal cell carcinoma. In: World Journal of Urology. 2016 ; pp. 1-9.
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abstract = "Objective: To assess the association of smoking status with standard clinicopathological features and overall survival (OS) in a large multi-institutional cohort of patients with metastatic renal cell carcinoma (mRCC) treated with cytoreductive nephrectomy (CNT). Methods: A total of 613 patients with mRCC treated with CNT in US and Europe institutions between 1990 and 2013 were included. Smoking history comprised smoking status, smoking duration in years, number of cigarettes per day and years since smoking cessation. Cumulative smoking exposure was categorized as light short term, heavy long term and moderate. Association between smoking history and OS was assessed by Cox regression logistic analysis. Results: One hundred and seventy-one patients (27.9 {\%}) never smoked, 193 (31.5 {\%}) were former smokers and 249 (40.6 {\%}) were current smokers. Smoking status was associated with a higher number of metastases (p <0.001) and an abnormal preoperative corrected calcium level (p = 0.01). Median follow-up was 16 (IQR 7–24) months. Current smokers had a shorter OS than never and former smokers (log rank, p = 0.004). Smoking status was significantly associated with OS in univariable analysis (HR 1.45; 95 {\%} CI 1.16–1.82; p <0.001), and in multivariable analysis that adjusted for established prognostic factors (HR 1.46; 95 {\%} CI 1.16–1.84; p = 0.002). Daily consumption of more than 20 cigarettes, more than 20 years of smoking exposure and heavy long exposure were all independent prognosticators of worse OS. Conclusions: Current smoking and a higher cumulative smoking exposure are associated with a higher risk of death in patients with mRCC treated with CNT. Even at this stage, smoking negatively affects kidney cancer outcomes.",
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T1 - Impact of smoking status on survival after cytoreductive nephrectomy for metastatic renal cell carcinoma

AU - Fajkovic, Harun

AU - Shariat, Shahrokh F.

AU - Klatte, Tobias

AU - Vartolomei, Mihai Dorin

AU - Lucca, Ilaria

AU - Mbeutcha, Aurélie

AU - Rouprêt, Morgan

AU - Briganti, Alberto

AU - Karakiewicz, Pierre I.

AU - Margulis, Vitaly

AU - Rink, Michael

AU - Remzi, Mesut

AU - Seitz, Christian

AU - Bensalah, Karim

AU - Mathieu, Romain

PY - 2016/2/15

Y1 - 2016/2/15

N2 - Objective: To assess the association of smoking status with standard clinicopathological features and overall survival (OS) in a large multi-institutional cohort of patients with metastatic renal cell carcinoma (mRCC) treated with cytoreductive nephrectomy (CNT). Methods: A total of 613 patients with mRCC treated with CNT in US and Europe institutions between 1990 and 2013 were included. Smoking history comprised smoking status, smoking duration in years, number of cigarettes per day and years since smoking cessation. Cumulative smoking exposure was categorized as light short term, heavy long term and moderate. Association between smoking history and OS was assessed by Cox regression logistic analysis. Results: One hundred and seventy-one patients (27.9 %) never smoked, 193 (31.5 %) were former smokers and 249 (40.6 %) were current smokers. Smoking status was associated with a higher number of metastases (p <0.001) and an abnormal preoperative corrected calcium level (p = 0.01). Median follow-up was 16 (IQR 7–24) months. Current smokers had a shorter OS than never and former smokers (log rank, p = 0.004). Smoking status was significantly associated with OS in univariable analysis (HR 1.45; 95 % CI 1.16–1.82; p <0.001), and in multivariable analysis that adjusted for established prognostic factors (HR 1.46; 95 % CI 1.16–1.84; p = 0.002). Daily consumption of more than 20 cigarettes, more than 20 years of smoking exposure and heavy long exposure were all independent prognosticators of worse OS. Conclusions: Current smoking and a higher cumulative smoking exposure are associated with a higher risk of death in patients with mRCC treated with CNT. Even at this stage, smoking negatively affects kidney cancer outcomes.

AB - Objective: To assess the association of smoking status with standard clinicopathological features and overall survival (OS) in a large multi-institutional cohort of patients with metastatic renal cell carcinoma (mRCC) treated with cytoreductive nephrectomy (CNT). Methods: A total of 613 patients with mRCC treated with CNT in US and Europe institutions between 1990 and 2013 were included. Smoking history comprised smoking status, smoking duration in years, number of cigarettes per day and years since smoking cessation. Cumulative smoking exposure was categorized as light short term, heavy long term and moderate. Association between smoking history and OS was assessed by Cox regression logistic analysis. Results: One hundred and seventy-one patients (27.9 %) never smoked, 193 (31.5 %) were former smokers and 249 (40.6 %) were current smokers. Smoking status was associated with a higher number of metastases (p <0.001) and an abnormal preoperative corrected calcium level (p = 0.01). Median follow-up was 16 (IQR 7–24) months. Current smokers had a shorter OS than never and former smokers (log rank, p = 0.004). Smoking status was significantly associated with OS in univariable analysis (HR 1.45; 95 % CI 1.16–1.82; p <0.001), and in multivariable analysis that adjusted for established prognostic factors (HR 1.46; 95 % CI 1.16–1.84; p = 0.002). Daily consumption of more than 20 cigarettes, more than 20 years of smoking exposure and heavy long exposure were all independent prognosticators of worse OS. Conclusions: Current smoking and a higher cumulative smoking exposure are associated with a higher risk of death in patients with mRCC treated with CNT. Even at this stage, smoking negatively affects kidney cancer outcomes.

KW - Cytoreductive nephrectomy

KW - Renal carcinoma

KW - Smoking status

KW - Survival

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