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      Association of Smoking Status With Recurrence, Metastasis, and Mortality Among Patients With Localized Prostate Cancer Undergoing Prostatectomy or Radiotherapy : A Systematic Review and Meta-analysis

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          Abstract

          Studies investigating the association of cigarette smoking with prostate cancer incidence and outcomes have revealed controversial results.

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          Most cited references28

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          Defining biochemical failure following radiotherapy with or without hormonal therapy in men with clinically localized prostate cancer: recommendations of the RTOG-ASTRO Phoenix Consensus Conference.

          In 1996 the American Society for Therapeutic Radiology and Oncology (ASTRO) sponsored a Consensus Conference to establish a definition of biochemical failure after external beam radiotherapy (EBRT). The ASTRO definition defined prostate specific antigen (PSA) failure as occurring after three consecutive PSA rises after a nadir with the date of failure as the point halfway between the nadir date and the first rise or any rise great enough to provoke initiation of therapy. This definition was not linked to clinical progression or survival; it performed poorly in patients undergoing hormonal therapy (HT), and backdating biased the Kaplan-Meier estimates of event-free survival. A second Consensus Conference was sponsored by ASTRO and the Radiation Therapy Oncology Group in Phoenix, Arizona, on January 21, 2005, to revise the ASTRO definition. The panel recommended: (1) a rise by 2 ng/mL or more above the nadir PSA be considered the standard definition for biochemical failure after EBRT with or without HT; (2) the date of failure be determined "at call" (not backdated). They recommended that investigators be allowed to use the ASTRO Consensus Definition after EBRT alone (no hormonal therapy) with strict adherence to guidelines as to "adequate follow-up." To avoid the artifacts resulting from short follow-up, the reported date of control should be listed as 2 years short of the median follow-up. For example, if the median follow-up is 5 years, control rates at 3 years should be cited. Retaining a strict version of the ASTRO definition would allow comparisons with a large existing body of literature.
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            The role of starches in etiology of gastric cancer

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              Smoking as a risk factor for prostate cancer: a meta-analysis of 24 prospective cohort studies.

              We evaluated the relationship between smoking and adenocarcinoma of the prostate. We pooled data from 24 cohort studies enrolling 21 579 prostate cancer case participants for a general variance-based meta-analysis. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated separately for mortality and incidence studies. We tested the robustness of effect measures and evaluated statistical heterogeneity with sensitivity analyses. In the pooled data, current smokers had no increased risk of incident prostate cancer (RR = 1.04; 95% CI = 0.87, 1.24), but in data stratified by amount smoked they had statistically significant elevated risk (cigarettes per day or years: RR = 1.22; 95% CI = 1.01, 1.46; pack years of smoking: RR = 1.11; 95% CI = 1.01, 1.22). Former smokers had an increased risk (RR = 1.09; 95% CI = 1.02, 1.16). Current smokers had an increased risk of fatal prostate cancer (RR = 1.14; 95% CI = 1.06, 1.19). The heaviest smokers had a 24% to 30% greater risk of death from prostate cancer than did nonsmokers. Observational cohort studies show an association of smoking with prostate cancer incidence and mortality. Ill-defined exposure categories in many cohort studies suggest that pooled data underestimate risk.
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                Author and article information

                Journal
                JAMA Oncology
                JAMA Oncol
                American Medical Association (AMA)
                2374-2437
                July 01 2018
                July 01 2018
                : 4
                : 7
                : 953
                Affiliations
                [1 ]Department of Urology, Medical University of Vienna, Vienna, Austria
                [2 ]Department of Urology, Kantonsspital Winterthur, Winterthur, Switzerland
                [3 ]Department of Urology, Hospital Universitario Fundación Alcorcón, Madrid, Spain
                [4 ]Division of Urology, Department of Special Surgery, Jordan University Hospital, The University of Jordan, Amman, Jordan
                [5 ]Department of Urology, Jikei University School of Medicine, Tokyo, Japan
                [6 ]Department of Urology, Weill Cornell Medical College, New York, New York
                [7 ]Department of Urology, University of Texas Southwestern Medical Center, Dallas
                [8 ]Karl Landsteiner Institute of Urology and Andrology, Vienna, Austria
                Article
                10.1001/jamaoncol.2018.1071
                6145736
                29800115
                1e84f87d-255f-4200-b148-1a04630497a6
                © 2018
                History

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