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Smoking is a risk factor for pulmonary metastasis in colorectal cancer
Author(s) -
Yahagi M.,
Tsuruta M.,
Hasegawa H.,
Okabayashi K.,
Toyoda N.,
Iwama N.,
Morita S.,
Kitagawa Y.
Publication year - 2017
Publication title -
colorectal disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.029
H-Index - 89
eISSN - 1463-1318
pISSN - 1462-8910
DOI - 10.1111/codi.13833
Subject(s) - medicine , colorectal cancer , metastasis , oncology , hazard ratio , lung cancer , risk factor , pulmonary fibrosis , cancer , pathological , proportional hazards model , lung , univariate analysis , multivariate analysis , gastroenterology , confidence interval
Abstract Aim The hepatic microenvironment, which may include chronic inflammation and fibrosis, is considered to contribute to the pathogenesis of liver metastases of colorectal cancer. A similar mechanism is anticipated for pulmonary metastases, although no reports are available. Smoking causes pulmonary inflammation and fibrosis. Thus, we hypothesized that smokers would be especially affected by pulmonary metastases of colorectal cancer. In this study, we attempted to clarify the impact of smoking on pulmonary metastasis of colorectal cancer. Method Between September 2005 and December 2010 we reviewed 567 patients with pathological Stage I, II or III colorectal cancer, whose clinicopathological background included a preoperative smoking history, pack‐year history from medical records. Univariate and multivariate analyses using the Cox proportional hazard model were performed to determine the independent prognostic factors for pulmonary metastasis‐free survival. Results Pulmonary metastases occurred in 39 (6.9%) patients. The smoking histories revealed 355 never smokers, 119 former smokers and 93 current smokers among the subjects. Multivariate analysis revealed that being a current smoker (hazard ratio = 2.72, 95% CI 1.18–6.25; P = 0.02) was an independent risk factor for pulmonary metastases. Conclusion Smoking may be a risk factor for pulmonary metastasis of colorectal cancer. Cessation of smoking should be recommended to prevent pulmonary metastasis, although further basic and clinical studies are required.