Smoking behavior and smoking index as prognostic indicators for patients with esophageal squamous cell carcinoma who underwent surgery: A large cohort study in Guangzhou, China

Abstract

INTRODUCTION This study aimed to evaluate the association between smoking and smoking index with clinical outcomes of esophageal squamous cell carcinoma patients. METHODS This is a retrospective analysis conducted on consecutive patients with esophageal carcinoma who underwent esophagectomy from January 2005 to December 2010. All patients had pathologically confirmed esophageal squamous cell carcinoma. The association between smoking and sociodemographic characteristics with overall survival and disease-free survival was analyzed. Serum carcinoembryonic antigen was measured using an electrochemiluminescence immunoassay. RESULTS A total of 944 patients were enrolled. Kaplan-Meier analysis indicated that esophageal squamous cell carcinoma patients who smoked had a significantly worse prognosis in terms of both overall survival (p=0.007) and disease-free survival (p= 0.010). Multivariate analysis demonstrated that age (p=0.001), carcinoembryonic antigen (p=0.012), tumor-node-metastasis (TNM) staging (p<0.001) and smoking (p=0.048) were independently correlated with overall survival, while only TNM stage (p<0.001) and smoking (p=0.041) were identified as independent factors of disease-free survival. We divided the smoking population into two groups (smoking index <400 and ≥400). Kaplan-Meier survival analysis indicated that a smoking index <400 was associated with a significantly better prognosis in terms of both overall survival (p=0.003) and favorable disease-free survival (p=0.032). Multivariate analysis showed that age (p<0.001), TNM staging (p<0.001), and smoking index (p=0.025) were independent factors of overall survival, whereas for disease-free survival, only TNM stage (p=0.001) and smoking index (p=0.025) were identified. CONCLUSIONS Overall survival was significantly associated with smoking in esophageal squamous cell carcinoma patients. For esophageal squamous cell carcinoma patients who smoke, a higher smoking index is associated with worse clinical outcomes. Therefore, smoking may be used as a predictive indicator for pretreatment evaluation and adjustment of treatment regimen.

Association Between Clinical Manifestations and Prognosis in Patients with COVID-19

“…Tobacco smoking has been confirmed to be associated with many diseases. 15,16 In our study, multivariate analysis suggests that high BMI and tobacco smoking were independent risk factors associated with disease exacerbation in 2019-nCoVeinfected patients after treatment. Until now, there have been no antiviral drugs specifically approved for treating 2019-nCoVeinfected patients.…”

Anti-inflammatory effects of rosuvastatin treatment in coronary artery ectasia patients in different age groups

“…In addition, younger patients responded more strongly to physical and emotional stimulation [39], which can lead to increased levels of in ammatory markers. There are other lifestyle factors that can also lead to in ammation, such as cocaine abuse and trauma [8].…”

“…Alterations in nitric oxide levels, in ammation, extracellular matrix degradation, dyslipidemia, and genetic predisposition are suspected mechanisms. Moreover, potential risk factors for CAE include an imbalance between matrix metalloproteinases (MMPs) and tissue inhibitor metalloproteinases (TIMPs), angiotensin-converting enzyme genotypes, a lower HDL cholesterol level, a higher low-density lipoprotein (LDL)/HDL ratio [6], elevated levels of homocysteine, cocaine usage, smoking, vascular trauma, and diabetes [7][8][9][10]. We followed a total of 217 patients, and divided them into four groups: the normal control (NC) group (n=73), CAE-A (n=60), CAE-B (n=83), and CAE-C (n=74) Figure 1.…”

Anti-inflammatory effects of rosuvastatin treatment on coronary artery ectasia patients of different age groups

“…This suggests that abnormal lipoprotein metabolism in individuals with FH predisposes patients to aneurysmal coronary artery disease [6]. Moreover, potential risk factors for CAE include an imbalance between matrix metalloproteinases (MMPs) and tissue inhibitor metalloproteinases (TIMPs), angiotensin-converting enzyme genotypes, a lower HDL cholesterol level, a higher low-density lipoprotein (LDL)/HDL ratio, elevated homocysteine levels, cocaine usage, smoking, vascular trauma, and diabetes [7][8][9][10]. Conventionally, CAE has been considered a variant of coronary atherosclerosis and an important clinical complication in interventional cardiology with increased thrombogenic potential of the ectatic arteries.…”