title: Pretreatment lifestyle behaviors as survival predictors for patients with nasopharyngeal carcinoma.
abstract: BACKGROUND
  Lifestyle behaviors have been widely reported to influence the survival of patients with head and neck cancer. However, the relationship between pretreatment lifestyle behaviors and survival among patients with nasopharyngeal carcinoma (NPC) is unclear.
  
  
  METHODS
  A prospective cohort study was designed to determine the relationship between lifestyle behaviors and survival in 1,533 NPC patients recruited from October 2005 to October 2007. Pretreatment lifestyle behaviors (such as body-mass index [BMI], smoking, alcohol, diet) of the patients were investigated. Univariate and multivariate proportional-hazards models were used to assess the impact of lifestyle behaviors on patient survival.
  
  
  RESULTS
  Smoking was a predictor of survival; both current smokers (hazard ratio [HR] = 1.88; 95% CI, 1.33 to 2.65) and heavy smokers (≥ 25 Pack-years; HR = 1.84; 95% CI, 1.30 to 2.60) showed associations with poor survival. Higher BMI was significantly associated with a lower risk of death (P(trend) = 0.002). Compared with under/normal-weight patients (BMI less than 22.99 kg/m(2)), the multivariate HR for survival was 0.66 (95% CI, 0.48 to 0.90) and 0.47 (95% CI, 0.23 to 0.97) for overweight and obese patients, respectively. No alcohol intake and high fruit intake were associated with favorable survival in the univariate analysis but lost significance in the multivariate model.
  
  
  CONCLUSIONS
  Our findings indicate that pretreatment lifestyle behaviors, especially smoking status and BMI, as easily available data, provide prognostic value for survival in NPC patients.
authors.affiliation: State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China.
authors.forename: Guo-Ping
authors.initials: GP
authors.lastname: Shen
authors.forename: Feng-Hua
authors.initials: FH
authors.lastname: Xu
authors.forename: Fen
authors.initials: F
authors.lastname: He
authors.forename: Hong-Lian
authors.initials: HL
authors.lastname: Ruan
authors.forename: Cui
authors.initials: C
authors.lastname: Cui
authors.forename: Li-Zhen
authors.initials: LZ
authors.lastname: Chen
authors.forename: Yi-Xin
authors.initials: YX
authors.lastname: Zeng
authors.forename: Wei-Hua
authors.initials: WH
authors.lastname: Jia
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D015992:Body Mass Index; D002277:Carcinoma; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D000077274:Nasopharyngeal Carcinoma; D009303:Nasopharyngeal Neoplasms / Q000401:mortality* / Q000628:therapy; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000401:mortality; D015996:Survival Rate; D017741:Survivors