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

Mikkel Bandak*, Kristine Skovly Nielsen, Michael Kreiberg, Thomas Wagner, Josephine Rosenvilde, Charlotta Pissinger, Christoffer Johansen, Gedske Daugaard, Jakob Lauritsen

*Corresponding author for this work


We investigated the impact of smoking on overall survival (OS) in testicular germ cell cancer (TC) patients receiving first-line combination chemotherapy (bleomycin-etoposide-cisplatin [BEP]). Patients who received BEP for metastatic TC were identified in the Danish Testicular Cancer database. Information on smoking status at the time of diagnosis was obtained by medical record review. OS and cause of death were compared between current smokers and never-smokers. Of 1883 eligible patients, information on smoking status was available in 1156 patients, of whom 602 were current smokers. The 10-year OS was 92% in never-smokers compared with 83% in current smokers (P < .001) (hazard ratio for death = 1.85, 95% confidence interval = 1.29 to 2.66, P = .001). A higher proportion of current smokers died of TC compared with nonsmokers (P < .01). Smoking negatively affects survival after BEP in patients with disseminated TC. Vigorous smoking cessation programs are advocated in TC patients.

Original languageEnglish
JournalJNCI-Journal of the National Cancer Institute
Issue number6
Pages (from-to)753-756
Number of pages4
Publication statusPublished - 8 Jun 2023


  • Antineoplastic Combined Chemotherapy Protocols/therapeutic use
  • Bleomycin/adverse effects
  • Cisplatin/adverse effects
  • Etoposide/adverse effects
  • Humans
  • Male
  • Neoplasms, Germ Cell and Embryonal/therapy
  • Prognosis
  • Smoking/adverse effects
  • Testicular Neoplasms/pathology


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