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Association of Smoking History with Cancer Recurrence and Survival in Stage III–IV Male Gastric Cancer Patients

2013; American Association for Cancer Research; Volume: 22; Issue: 10 Linguagem: Inglês

10.1158/1055-9965.epi-13-0385

1538-7755

Mi Ah Han, Young–Woo Kim, Il Ju Choi, Myueng Guen Oh, Chan Gyoo Kim, Jong Yeul Lee, Soo‐Jeong Cho, Bang Wool Eom, Hong Man Yoon, Keun Won Ryu,

Cancer, Lipids, and Metabolism

Abstract Background: Smoking and drinking alcohol are major risk factors for cancer development, and we investigated their effects on gastric cancer prognosis following initial resection. Methods: Data from male patients with stage III–IV gastric adenocarcinoma who underwent surgery between 2001 and 2006 were retrospectively reviewed. Patients were followed up until 2011. Kaplan–Meier plots and Cox proportional hazards regressions were applied for survival rates. Results: Among 238 patients, 151 (63.4%) smoked and 146 (61.3%) drank alcohol. Current smokers had an increased risk of cancer recurrence or death from any cause [adjusted HR (aHR), 1.94; 95% confidence interval (CI), 1.18–3.21], cancer recurrence (aHR, 1.89; 95% CI, 1.12–3.21), and overall mortality (aHR, 2.14; 95% CI, 1.23–3.73) compared with never-smokers. Patients with a lifetime cigarette smoking of <40 and ≥40 pack-years had increased cancer recurrence or death from any cause (aHR, 1.72 and 2.43, respectively; 95% CI, 1.03–2.86 and 1.38–4.30, respectively), cancer recurrence (aHR, 1.63 and 2.61, respectively; 95% CI, 0.95–2.79 and 1.43–4.77, respectively), and overall mortality (aHR, 1.92 and 2.75, respectively; 95% CI, 1.09–3.38 and 1.47–5.12, respectively) compared with never-smokers. However, drinking alcohol was not associated with postsurgery survival. Conclusions: Cigarette-smoking history at the time of diagnosis, but not drinking history, is associated with cancer recurrence and poor survival after surgery in male patients with stage III–IV gastric cancer. Impact: These findings encourage physicians to advise patients with gastric cancer to stop smoking to obtain a general health benefit and likely improvement in the gastric cancer course. Cancer Epidemiol Biomarkers Prev; 22(10); 1805–12. ©2013 AACR.