Open AccessPrediagnostic smoking and postoperative survival in lymph node‐negative esophagus squamous cell carcinoma patients
Author(s) -
Lin Yongbin,
Su Xiaodong,
Su Hongyu,
Lin Peng,
Long Hao,
Zhang Lanjun,
Fu Jianhua,
Rong Tiehua,
Tan Zihui,
Meng Yuqi,
Ma Guowei
Publication year - 2012
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.12000
Subject(s) - medicine , lymph node , esophagectomy , esophagus , multivariate analysis , esophageal cancer , risk factor , hazard ratio , carcinoma , oncology , gastroenterology , cancer , lymph , proportional hazards model , pathology , confidence interval
Smoking is well known as a risk factor for esophageal cancer, but controversial as a prognostic factor. Moreover, evidence is scarce that a dose–response relationship exists. We conducted a retrospective study on the effect and dose–response relationship of prediagnostic smoking on the postoperative disease‐specific survival of patients with lymph node‐negative esophageal squamous cell carcinoma ( ESCC ). We enrolled 643 patients with lymph node‐negative ESCC who had undergone esophagectomy between 1990 and 2005 at the D epartment of T horacic S urgery, Sun Y at‐sen U niversity C ancer C enter, G uangzhou, C hina. The patients' demographic, pathological, preoperative and cancer outcome data were obtained from medical records. These data were reviewed and analyzed using life table, K aplan– M eier analysis and multivariate C ox regression. A significant reduction in 3‐ and 5‐year survival rates was observed in smokers with lymph node‐negative ESCC compared with those in non‐smokers. The 3‐ and 5‐year survival rates were 54% and 46% for smokers, and 67% and 64% for non‐drinkers, respectively ( P < 0.05). Multivariate C ox analysis revealed that smoking was an independent prognostic factor ( P = 0.008, hazard ratio = 1.404). Both log‐rank test ( P = 0.065) and multivariate analysis ( P = 0.091) showed no significant difference between the survival rates of light and heavy smokers. Prediagnostic smoking is an independent prognostic factor for patients with lymph node‐negative ESCC , but the dose–response relationship needs further investigation.