title: Association of smoking history with cancer recurrence and survival in stage III-IV male gastric cancer patients.
abstract: BACKGROUND
  Smoking and drinking alcohol are major risk factors for cancer development, and we investigated their effects on gastric cancer prognosis following initial resection.
  
  
  METHODS
  Data from male patients with stage III-IV gastric adenocarcinoma who underwent surgery between 2001 and 2006 were retrospectively reviewed. Patients were followed up until 2011. Kaplan-Meier plots and Cox proportional hazards regressions were applied for survival rates.
  
  
  RESULTS
  Among 238 patients, 151 (63.4%) smoked and 146 (61.3%) drank alcohol. Current smokers had an increased risk of cancer recurrence or death from any cause [adjusted HR (aHR), 1.94; 95% confidence interval (CI), 1.18-3.21], cancer recurrence (aHR, 1.89; 95% CI, 1.12-3.21), and overall mortality (aHR, 2.14; 95% CI, 1.23-3.73) compared with never-smokers. Patients with a lifetime cigarette smoking of <40 and ≥ 40 pack-years had increased cancer recurrence or death from any cause (aHR, 1.72 and 2.43, respectively; 95% CI, 1.03-2.86 and 1.38-4.30, respectively), cancer recurrence (aHR, 1.63 and 2.61, respectively; 95% CI, 0.95-2.79 and 1.43-4.77, respectively), and overall mortality (aHR, 1.92 and 2.75, respectively; 95% CI, 1.09-3.38 and 1.47-5.12, respectively) compared with never-smokers. However, drinking alcohol was not associated with postsurgery survival.
  
  
  CONCLUSIONS
  Cigarette-smoking history at the time of diagnosis, but not drinking history, is associated with cancer recurrence and poor survival after surgery in male patients with stage III-IV gastric cancer.
  
  
  CONCLUSIONS
  These findings encourage physicians to advise patients with gastric cancer to stop smoking to obtain a general health benefit and likely improvement in the gastric cancer course.
authors.affiliation: Authors' Affiliations: Department of Preventive Medicine, College of Medicine; Department of Medicine, Graduate School, Chosun University, Gwangju; Center for Gastric Cancer, National Cancer Center, Goyang; and Department of Internal Medicine, Haengchon Medical Foundation, Haenam General Hospital, Haenam, Republic of Korea.
authors.forename: Mi Ah
authors.initials: MA
authors.lastname: Han
authors.forename: Young-Woo
authors.initials: YW
authors.lastname: Kim
authors.forename: Il Ju
authors.initials: IJ
authors.lastname: Choi
authors.forename: Myueng Guen
authors.initials: MG
authors.lastname: Oh
authors.forename: Chan Gyoo
authors.initials: CG
authors.lastname: Kim
authors.forename: Jong Yeul
authors.initials: JY
authors.lastname: Lee
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Cho
authors.forename: Bang Wool
authors.initials: BW
authors.lastname: Eom
authors.forename: Hong Man
authors.initials: HM
authors.lastname: Yoon
authors.forename: Keun Won
authors.initials: KW
authors.lastname: Ryu
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000453:epidemiology / Q000473:pathology; D018572:Disease-Free Survival; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology*; D013274:Stomach Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D016019:Survival Analysis