Smoking as a prognostic factor for survival in patients with disseminated germ cell cancer.

We investigated the impact of smoking on overall survival (OS) in testicular germ cell cancer (TC) patients receiving first line combination chemotherapy (BEP). Patients who received BEP for metastatic TC were identified in the Danish Testicular Cancer (DaTeCa) database. Information on smoking status at the time of diagnosis was obtained by medical record review. OS and cause of death was compared between current smokers and never-smokers Of 1,883 eligible patients, information on smoking status was available in 1,156 patients, of whom 602 were current smokers. 10-year OS was 92% in never-smokers compared to 83% in current smokers (P < 0.001), hazard ratio for death: 1.85, 95% confidence interval (1.29-2.66), (P = 0.001). A higher proportion of current smokers died of TC compared to non-smokers (P < 0.01). Smoking negatively impacts survival after BEP in patients with disseminated TC. Vigorous smoking cessation programmes are advocated in TC patients.