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

Abstract:

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.

journal_name

World J Gastroenterol

authors

Zhao LL,Huang H,Wang Y,Wang TB,Zhou H,Ma FH,Ren H,Niu PH,Zhao DB,Chen YT

doi

10.3748/wjg.v26.i14.1613

subject

Has Abstract

pub_date

2020-04-14 00:00:00

pages

1613-1627

issue

14

eissn

1007-9327

issn

2219-2840

journal_volume

26

pub_type

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