title: Smoking affects treatment outcome in patients with resected esophageal squamous cell carcinoma who received chemotherapy.
abstract: BACKGROUND
  Cigarette smoking is reported to decrease survival and induce chemotherapy resistance in patients with various cancers. However, the impact of cigarette smoking on patients with esophageal squamous cell carcinoma (ESCC) remains unknown.
  
  
  METHODS
  A total of 1,084 ESCC patients were retrospectively enrolled from a southern Chinese institution. Patients were divided into two groups according to their treatment modalities: the SC group (surgery with chemotherapy) (n = 306) and the S group (surgery without chemotherapy) (n = 778). Smoking status was quantified as smoking history (non-smoker, ex-smoker, and current smoker) and cumulative smoking (0, between 0 and 20, and greater than 20 pack-years). The association between cigarette smoking and overall survival (OS) was evaluated using the Kaplan-Meier method and univariate/multivariate regression analysis.
  
  
  RESULTS
  Among 1,084 patients, 702 (64.8%) reported a cigarette smoking history, and the 5-year OS for non-smokers and smokers was 45.8% and 37.3%, respectively. In the SC group, compared with non-smoker, the adjusted HRs of ex-smoker and current smoker were 1.540 (95% CI, 1.1-2.2) and 2.110 (95% CI, 1.4-3.1), respectively; there is a correlative trend of decreased OS with increased cigarette smoking (Ptrend = 0.001). These associations were insignificant in the S group. In subgroup analysis of the SC group, the lower OS conferred by smoking was not significantly modified by age, gender, body mass index, alcohol drinking, or chemotherapy method (chemotherapy and chemoradiotherapy).
  
  
  CONCLUSIONS
  Our results suggest that smoking may affect treatment outcome in patients with resected ESCC who received chemotherapy.
authors: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China.
authors: Yuzhen
authors: Y
authors: Zheng
authors: Department of Intensive Care Unit, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China.
authors: Xun
authors: X
authors: Cao
authors: Department of Experimental Research, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China.
authors: Jing
authors: J
authors: Wen
authors: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China.
authors: Hong
authors: H
authors: Yang
authors: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China.
authors: Kongjia
authors: K
authors: Luo
authors: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China.
authors: Qianwen
authors: Q
authors: Liu
authors: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China.
authors: Qingyuan
authors: Q
authors: Huang
authors: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China.
authors: Junying
authors: J
authors: Chen
authors: Department of Thoracic Oncology, Sun Yat-sen University Cancer Center; State Key Laboratory of Oncology in South China; Collaborative Innovation, Guangzhou, Guangdong, P.R. China; Guangdong Esophageal Cancer Institute, Guangzhou, Guangdong, P.R. China.
authors: Jianhua
authors: J
authors: Fu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D002681:China; D003131:Combined Modality Therapy; D004938:Esophageal Neoplasms / Q000150:complications* / Q000188:drug therapy* / Q000401:mortality / Q000601:surgery; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012907:Smoking / Q000009:adverse effects*; D016896:Treatment Outcome