Open Access

Prognostic impact of cigarette smoking on the survival of patients with established esophageal squamous cell carcinoma receiving radiotherapy: A retrospective study from southern China

  • Authors:
    • Guo‑Rong Zou
    • Zhen Su
    • Jun‑Yun Li
    • Fang‑Yun Xie
    • Qun Li
  • View Affiliations

  • Published online on: March 7, 2019     https://doi.org/10.3892/etm.2019.7356
  • Pages: 3671-3681
  • Copyright: © Zou et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Cigarette smoking is associated with the development of esophageal squamous cell carcinoma (ESCC); however, the influence of smoking on survival of patients with ESCC receiving radiotherapy, with or without chemotherapy, has remained elusive. The present study retrospectively analyzed 479 patients with ESCC from southern China who were categorized based on their smoking history (never, previous or current). To consider the cumulative effect of smoking, the number of pack years (PYs) was used as a representative variable. Associations between cigarette smoking and survival were evaluated using the Kaplan‑Meier analysis and Cox proportional hazards model. Among the 497 patients, 308 (64.3%) had reported a history of cigarette smoking. The 5‑year overall survival for patients void of a smoking history, former smokers and current smokers was 50.9, 27.0 and 34.3%, respectively. The adjusted hazard ratios (HRs) for previous and current smoking vs. no smoking history were 1.57 [95% confidence interval (CI), 1.06‑2.32] and 3.01 (95% CI, 1.15‑7.86), respectively. Heavy smokers with a high number of PYs had a HR for death of 1.75 (95% CI, 1.28‑2.41) compared with light smokers. In the cohort of 407 patients treated with intensity‑modulated radiotherapy/three‑dimensional conformal radiotherapy, similarly significant results were obtained. In conclusion, cigarette smoking is an independent and poor prognostic factor for patients with ESCC treated with radiotherapy and/or chemotherapy. It is associated with an increased risk of death, and the risk increases with the increase in PYs. This result may help to manage tobacco use among patients with ESCC. The smoking status should be taken into consideration in prospective studies on ESCC. More frequent follow‑ups are recommended for those patients with ESCC with a history of smoking.
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May-2019
Volume 17 Issue 5

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Zou GR, Su Z, Li JY, Xie FY and Li Q: Prognostic impact of cigarette smoking on the survival of patients with established esophageal squamous cell carcinoma receiving radiotherapy: A retrospective study from southern China. Exp Ther Med 17: 3671-3681, 2019
APA
Zou, G., Su, Z., Li, J., Xie, F., & Li, Q. (2019). Prognostic impact of cigarette smoking on the survival of patients with established esophageal squamous cell carcinoma receiving radiotherapy: A retrospective study from southern China. Experimental and Therapeutic Medicine, 17, 3671-3681. https://doi.org/10.3892/etm.2019.7356
MLA
Zou, G., Su, Z., Li, J., Xie, F., Li, Q."Prognostic impact of cigarette smoking on the survival of patients with established esophageal squamous cell carcinoma receiving radiotherapy: A retrospective study from southern China". Experimental and Therapeutic Medicine 17.5 (2019): 3671-3681.
Chicago
Zou, G., Su, Z., Li, J., Xie, F., Li, Q."Prognostic impact of cigarette smoking on the survival of patients with established esophageal squamous cell carcinoma receiving radiotherapy: A retrospective study from southern China". Experimental and Therapeutic Medicine 17, no. 5 (2019): 3671-3681. https://doi.org/10.3892/etm.2019.7356