Correlation between smoking habit and surgical outcomes on viral-associated hepatocellular carcinomas.
Correlation between smoking habit and surgical outcomes on viral-associated hepatocellular carcinomas.
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DOI：
10.3748/wjg.v24.i1.58
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发表时间：
2018-01-07
影响因子：
4.3
通讯作者：
Noshiro H
中科院分区：
文献类型：
--
作者：
Kai K;Komukai S;Koga H;Yamaji K;Ide T;Kawaguchi A;Aishima S;Noshiro H
探讨吸烟习惯与B型肝炎病毒（HBV）相关肝细胞癌（HCC）（B-HCC）和丙型肝炎病毒（HCV）相关HCC（C-HCC）手术结局的关系，并阐明B-HCC和C-HCC患者与吸烟状态相关的临床病理特征。我们回顾性研究了341例连续的病毒相关性HCC患者（C-HCC，n = 273; B-HCC，n = 68），这些患者接受了原发病灶的根治性手术。我们将手术时的吸烟状况分为从不吸烟者、既往吸烟者和当前吸烟者。我们分析了B-HCC和C-HCC组的临床病理特征和手术结果，即，无病生存期（DFS）、总生存期（OS）和疾病特异性生存期（DSS）。采用考克斯比例风险回归模型进行单变量和多变量分析。我们还在两个患者组中进行了亚组分析，将当前吸烟者与其他患者进行比较。C-HCC组的多变量分析显示，当前吸烟状态与OS（P = 0.0039）和DSS（P = 0.0416）显著相关。在B-HCC患者中，在单变量或多变量分析中未观察到当前吸烟状态与DFS、OS或DSS之间存在显著相关性。在C-HCC和B-HCC组中，将当前吸烟者与其他患者进行比较的亚组分析显示，无论病毒感染状态如何，当前吸烟者发生HCC的年龄明显低于其他患者。吸烟习惯与C-HCC患者的总体和疾病特异性生存率显著相关。相比之下，B-HCC患者的吸烟状况和手术结果之间的相关性较弱。
To investigate the association between smoking habits and surgical outcomes in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) (B-HCC) and hepatitis C virus (HCV)-related HCC (C-HCC) and clarify the clinicopathological features associated with smoking status in B-HCC and C-HCC patients. We retrospectively examined the cases of the 341 consecutive patients with viral-associated HCC (C-HCC, n = 273; B-HCC, n = 68) who underwent curative surgery for their primary lesion. We categorized smoking status at the time of surgery into never, ex- and current smoker. We analyzed the B-HCC and C-HCC groups’ clinicopathological features and surgical outcomes, i.e., disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS). Univariate and multivariate analyses were performed using a Cox proportional hazards regression model. We also performed subset analyses in both patient groups comparing the current smokers to the other patients. The multivariate analysis in the C-HCC group revealed that current-smoker status was significantly correlated with both OS (P = 0.0039) and DSS (P = 0.0416). In the B-HCC patients, no significant correlation was observed between current-smoker status and DFS, OS, or DSS in the univariate or multivariate analyses. The subset analyses comparing the current smokers to the other patients in both the C-HCC and B-HCC groups revealed that the current smokers developed HCC at significantly younger ages than the other patients irrespective of viral infection status. A smoking habit is significantly correlated with the overall and disease-specific survivals of patients with C-HCC. In contrast, the B-HCC patients showed a weak association between smoking status and surgical outcomes.
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