Associations of cigarette smoking and alcohol drinking with stomach cancer survival: A prospective patient cohort study in Japan

作者：Minami Yuko^*; Kanemura Seiki; Oikawa Tomoyuki; Suzuki Shinichi; Hasegawa Yasuhiro; Miura Koh; Nishino Yoshikazu; Kakugawa Yoichiro; Fujiya Tsuneaki

来源：International Journal of Cancer, 2018, 143(5): 1072-1085.

DOI：10.1002/ijc.31408

• stomach cancer
• smoking
• alcohol
• cohort study
• survival

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.

• 出版日期2018-9-1