Lifestyle factors and long-term survival of gastric cancer patients:A large bidirectional cohort study from China  

作　　者：Lu-Lu Zhao Huang Huang Yang Wang Tong-Bo Wang Hong Zhou Fu-Hai Ma Hu Ren Peng-Hui Niu Dong-Bing Zhao Ying-Tai Chen 

机构地区：[1]National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100021,China [2]Department of Environmental Health Sciences,Yale University School of Public Health,New Haven,CT 06520,United States [3]Department of General Surgery,Beijing Di Tan Hospital,Capital Medical University,Beijing 100015,China

出　　处：《World Journal of Gastroenterology》2020年第14期1613-1627,共15页世界胃肠病学杂志（英文版）

基　　金：National Key R&D Program of China,No.2017YFC0908300.

摘　　要：BACKGROUND Lifestyle factors such as body mass index(BMI),alcohol drinking,and cigarette smoking,are likely to impact the prognosis of gastric cancer,but the evidence has been inconsistent.AIM To investigate the association of lifestyle factors and long-term prognosis of gastric cancer patients in the China National Cancer Center.METHODS Patients with gastric cancer were identified from the China National Cancer Center Gastric Cancer Database 1998-2018.Survival analysis was performed via Kaplan-Meier estimates and Cox proportional hazards models.RESULTS In this study,we reviewed 18441 cases of gastric cancer.Individuals who were overweight or obese were associated with a positive smoking and drinking history(P=0.002 and P<0.001,respectively).Current smokers were more likely to be current alcohol drinkers(61.3%vs 10.1%vs 43.2%for current,never,and former smokers,respectively,P<0.001).Multivariable results indicated that BMI at diagnosis had no significant effect on prognosis.In gastrectomy patients,factors independently associated with poor survival included older age(HR=1.20,95%CI:1.05-1.38,P=0.001),any weight loss(P<0.001),smoking history of more than 30 years(HR=1.14,95%CI:1.04-1.24,P=0.004),and increasing pTNM stage(P<0.001).CONCLUSION In conclusion,our results contribute to a better understanding of lifestyle factors on the overall burden of gastric cancer and long-term prognosis.In these patients,weight loss(both in the 0 to 10%and>10%groups)but not BMI at diagnosis was related to survival outcomes.With regard to other factors,smoking history of more than 30 years conferred a worse prognosis only in patients who underwent gastrectomy.Extensive efforts are needed to elucidate mechanisms targeting the complex effects of lifestyle factors.

关 键 词：GASTRIC cancer LIFESTYLE factors Prognosis COHORT study Body mass index CIGARETTE SMOKING 

分 类 号：R735.2[医药卫生—肿瘤]