Open AccessSmoking Affects Treatment Outcome in Patients with Resected Esophageal Squamous Cell Carcinoma Who Received Chemotherapy
Author(s) -
Yuzhen Zheng,
Xun Cao,
Jing Wen,
Hong Yang,
Kongjia Luo,
Qianwen Liu,
Qingyuan Huang,
Junying Chen,
Jianhua Fu
Publication year - 2015
Publication title -
plos one
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.99
H-Index - 332
ISSN - 1932-6203
DOI - 10.1371/journal.pone.0123246
Subject(s) - medicine , chemotherapy , chemoradiotherapy , univariate analysis , multivariate analysis , esophageal squamous cell carcinoma , cigarette smoking , body mass index , subgroup analysis , gastroenterology , esophageal cancer , oncology , carcinoma , cancer , confidence interval
Background Cigarette smoking is reported to decrease survival and induce chemotherapy resistance in patients with various cancers. However, the impact of cigarette smoking on patients with esophageal squamous cell carcinoma (ESCC) remains unknown. Methods A total of 1,084 ESCC patients were retrospectively enrolled from a southern Chinese institution. Patients were divided into two groups according to their treatment modalities: the SC group (surgery with chemotherapy) ( n = 306) and the S group (surgery without chemotherapy) ( n = 778). Smoking status was quantified as smoking history (non-smoker, ex-smoker, and current smoker) and cumulative smoking (0, between 0 and 20, and greater than 20 pack-years). The association between cigarette smoking and overall survival (OS) was evaluated using the Kaplan-Meier method and univariate/multivariate regression analysis. Results Among 1,084 patients, 702 (64.8%) reported a cigarette smoking history, and the 5-year OS for non-smokers and smokers was 45.8% and 37.3%, respectively. In the SC group, compared with non-smoker, the adjusted HRs of ex-smoker and current smoker were 1.540 (95% CI, 1.1–2.2) and 2.110 (95% CI, 1.4–3.1), respectively; there is a correlative trend of decreased OS with increased cigarette smoking ( P trend = 0.001). These associations were insignificant in the S group. In subgroup analysis of the SC group, the lower OS conferred by smoking was not significantly modified by age, gender, body mass index, alcohol drinking, or chemotherapy method (chemotherapy and chemoradiotherapy). Conclusion Our results suggest that smoking may affect treatment outcome in patients with resected ESCC who received chemotherapy.