Smoking compromises cause-specific survival in patients with operable colorectal cancer
Smoking compromises cause-specific survival in patients with operable colorectal cancer
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DOI：
10.1016/j.clon.2006.04.009
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发表时间：
2006-08-01
影响因子：
3.4
通讯作者：
Boyle, P. J.
中科院分区：
文献类型：
--
作者：
Munro, A. J.;Bentley, A. H. M.;Boyle, P. J.
目的：评估主动吸烟是否会影响结直肠癌患者的生存。材料和方法：我们研究了一项基于地区的队列研究，包括284例连续转介到Tayside癌症中心的患者，以考虑结肠直肠癌根治性手术后的辅助治疗。结果：术后第一次就诊时积极吸烟的患者的病因特异性生存率明显较差（P = 0.0015）。5年病因特异性生存率（积极吸烟者与其他吸烟者）的绝对差异为21%。在病理完全切除（RO）后患者的校正多因素分析中，与非吸烟者相比，活跃吸烟者的风险比为2.55（95%可信区间1.40-4.64）。T分期、阳性淋巴结数和合并症评分也是影响预后的独立因素。结论：在这个小系列研究中，持续吸烟是大肠癌术后癌症相关死亡的一个重要且独立的预测因素。由于吸烟和剥夺相关，剥夺对这组患者生存的一些不利影响可以用吸烟行为来解释。
Aims: To assess whether active smoking compromises survival in patients with colorectal cancer.Materials and methods: We studied a regionally based cohort of 284 consecutive patients referred to the Tayside Cancer Centre for consideration of adjuvant treatment after curative surgery for colorectal cancer.Results: Cause-specific survival was significantly worse (P = 0.0015) in patients who were actively smoking at the time of their first post-operative visit. The absolute difference in 5-year cause-specific survival (active smokers vs the rest) was 21%. In adjusted multi-variate analysis of patients after pathologically complete (RO) resection, the hazard ratio was 2.55 (95% confidence interval 1.40-4.64) in active smokers compared with non-smokers. T stage, number of positive nodes and co-morbidity score were also of independent prognostic influence.Conclusions: Persistent smoking was, in this small series, an important and independent predictor of cancer-related death after surgery for cancer of the large bowel. Because smoking and deprivation are related, some of the adverse effects of deprivation upon survival in this group of patients may be explained by smoking behaviour.