MP50-06 COMPARATIVE ANALYSIS OF SMOKING AS A RISK FACTOR AMONG RENAL CELL CARCINOMA HISTOLOGIC SUBTYPES

Abstract

You have accessJournal of UrologyKidney Cancer: Evaluation and Staging III1 Apr 2015MP50-06 COMPARATIVE ANALYSIS OF SMOKING AS A RISK FACTOR AMONG RENAL CELL CARCINOMA HISTOLOGIC SUBTYPES Neel Patel, Kristopher Attwood, Terrance Creighton, Diana Mehedint, Michael Hanzly, Thomas Schwaab, and Eric Kauffman Neel PatelNeel Patel More articles by this author , Kristopher AttwoodKristopher Attwood More articles by this author , Terrance CreightonTerrance Creighton More articles by this author , Diana MehedintDiana Mehedint More articles by this author , Michael HanzlyMichael Hanzly More articles by this author , Thomas SchwaabThomas Schwaab More articles by this author , and Eric KauffmanEric Kauffman More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2015.02.1671AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Smoking is the best established modifiable risk factor for renal cell cancer (RCC), but the risk for developing individual RCC histologic subtypes with smoking is unknown. We investigated the relationship between smoking and RCC subtype. METHODS Smoking data was collected from 819 consecutive patients with either non-familial RCC (N=707) or benign pathology (N=112) undergoing nephrectomy at a single National Comprehensive Cancer Network cancer center, and retrospectively tested for statistical association with histologic diagnosis (benign, clear cell RCC, papillary RCC, chromophobe RCC or other RCC) in univariable and multivariable analyses. RESULTS A positive smoking history was reported by 51.4% of patients. Active smoking was nearly twice as common with clear cell (21.4%) or papillary (24.0%) RCC as with benign histology (12.5%, p<0.05 each), yet strikingly uncommon with chromophobe RCC (5.7%, p<0.05 vs. clear cell or papillary, Figure 1). Any smoking history (i.e., active or former) was similarly less common with chromophobe (31.5%) compared to clear cell (52.7%, p<0.05) or papillary (58.3%, p<0.05) RCC histology (Figure 1). Chromophobe RCC diagnosis was five times more likely if a patient was not actively smoking (p<0.01). Smoking extent (mean pack-years, mpy) was significantly greater with clear cell (14.6 mpy) or papillary (14.3 mpy), but not chromophobe RCC (9.3 mpy), compared to benign histology (8.7 mpy, Figure 2), and similar relationships were observed for mean packs per day. In multivariable analyses adjusting for age, gender, race, BMI, tumor size and stage, both clear cell and papillary but not chromophobe RCC were independently associated with active smoking (OR >2.0 each). CONCLUSIONS Traditional understanding of smoking as a RCC risk factor applies to the clear cell and papillary subtypes, but not the chromophobe subtype. These findings underscore distinct molecular carcinogenic mechanisms underlying the different RCC subtypes, and identify smoking as novel clinical variable aiding in RCC histologic subtype prediction. © 2015 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 193Issue 4SApril 2015Page: e613 Advertisement Copyright & Permissions© 2015 by American Urological Association Education and Research, Inc.MetricsAuthor Information Neel Patel More articles by this author Kristopher Attwood More articles by this author Terrance Creighton More articles by this author Diana Mehedint More articles by this author Michael Hanzly More articles by this author Thomas Schwaab More articles by this author Eric Kauffman More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...