Associations of cigarette smoking and alcohol drinking with stomach cancer survival: A prospective patient cohort study in Japan
Associations of cigarette smoking and alcohol drinking with stomach cancer survival: A prospective patient cohort study in Japan
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DOI：
10.1002/ijc.31408
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发表时间：
2018-09-01
影响因子：
6.4
通讯作者：
Fujiya, Tsuneaki
中科院分区：
文献类型：
--
作者：
Minami, Yuko;Kanemura, Seiki;Fujiya, Tsuneaki
吸烟和饮酒可能影响胃癌的预后，但证据并不一致。我们调查了1997-2010年在日本一家医院诊断的1576例组织学证实的胃癌患者，研究前吸烟和饮酒与全因和胃癌死亡风险之间的关系。吸烟和饮酒史使用自我管理的问卷进行评估。随访至2013年12月31日。采用Cox比例风险模型估计风险比（hr）和95%置信区间（ci）。在9625.1人年期间，670例全因胃癌死亡和419例胃癌死亡被记录在案。在所有患者中，经常饮酒与全因死亡风险增加显著相关（HR: 1.25; 95% CI: 1.03-1.51），但与胃癌死亡无关。观察到全因死亡风险与饮酒频率（p（趋势）=0.02）和每天饮酒量（p（趋势）=0.03）呈正相关。吸烟与患全因癌或胃癌死亡的风险无关。相反，在接受根治性切除的患者中，发现吸烟与胃癌死亡风险之间存在显著正相关（HR: 2.44; 95% CI: 1.17-5.08）。开始吸烟的年龄越早，也存在正相关（p（趋势）=0.0046）。前处理吸烟和饮酒对胃癌生存有显著影响。一生中生活方式的调整可以提高生存率。有什么新鲜事吗?虽然吸烟和饮酒被怀疑与胃癌预后有关，但支持这些联系的证据尚无定论。在这项对日本1500多名胃癌患者的研究中，关于吸烟和饮酒史的问卷调查显示，经常饮酒与全因死亡之间存在正相关，但与胃癌死亡无关。在接受治愈性胃癌切除术的患者中，长期吸烟与胃癌死亡风险升高有关，但与死亡风险无关。长期吸烟与胃癌死亡之间的联系在青少年开始吸烟的治愈患者中尤为突出。
Cigarette smoking and alcohol drinking may affect the prognosis of stomach cancer, but evidence has been inconsistent. We investigated the associations between pretreatment smoking and alcohol drinking and the risk of all-cause and stomach cancer death among 1,576 patients with histologically confirmed stomach cancer diagnosed during 1997-2010 at a single hospital in Japan. Histories of smoking and alcohol drinking were assessed using a self-administered questionnaire. The patients were followed until December 31, 2013. The Cox proportional hazards model was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). During 9,625.1 person-years, 670 all-cause and 419 stomach cancer deaths were documented. Among the patients overall, ever-drinking was significantly associated with an increased risk of all-cause death (HR: 1.25; 95% CI: 1.03-1.51), but not stomach cancer death. Positive linear associations with the frequency of drinking (p(trend)=0.02) and the amount of alcohol consumed per day (p(trend)=0.03) were observed for the risk of all-cause death. Ever-smoking was not related to either the risk of all-cause or stomach cancer death. Conversely, among the patients who underwent curative resection, a significant positive association was found between ever-smoking and the risk of stomach cancer death (HR: 2.44; 95% CI: 1.17-5.08). A positive association was also found for earlier age at start of smoking (p(trend)=0.0046). Pretreatment smoking and alcohol drinking have significant effects on stomach cancer survival. Lifestyle adjustments throughout life may improve survival.What's new? While cigarette smoking and alcohol consumption are suspected of being associated with stomach cancer prognosis, evidence supporting these links is inconclusive. In this study of more than 1,500 stomach cancer patients in Japan, questionnaires on smoking and alcohol consumption history reveal a positive association between ever-drinking and all-cause death but not death from stomach cancer. Ever-smoking was linked to an elevated risk of stomach cancer death in patients who underwent curative resection but was otherwise not associated with risk of death. The association between ever-smoking and stomach cancer death was prominent among curative patients who started smoking as teenagers.