title: Impact of smoking habit on surgical outcomes in non-B non-C patients with curative resection for hepatocellular carcinoma.
abstract: OBJECTIVE
  To analyzed the correlation between smoking status and surgical outcomes in patients with non-B non-C hepatocellular carcinoma (NBNC-HCC), and we investigated the patients' clinicopathological characteristics according to smoking status.
  
  
  METHODS
  We retrospectively analyzed the consecutive cases of 83 NBNC-HCC patients who underwent curative surgical treatment for the primary lesion at Saga University Hospital between 1984 and December 2012. We collected information about possibly carcinogenic factors such as alcohol abuse, diabetes mellitus, obesity and smoking habit from medical records. Smoking habits were subcategorized as never, ex- and current smoker at the time of surgery. The diagnosis of non-alcoholic steatohepatitis (NASH) was based on both clinical information and pathological confirmation.
  
  
  RESULTS
  Alcohol abuse, diabetes mellitus, obesity and NASH had no significant effect on the surgical outcomes. Current smoking status was strongly correlated with both overall survival (P= 0.0058) and disease-specific survival (P= 0.0105) by multivariate analyses. Subset analyses revealed that the current smokers were significantly younger at the time of surgery (P= 0.0002) and more likely to abuse alcohol (P= 0.0188) and to have multiple tumors (P= 0.023).
  
  
  CONCLUSIONS
  Current smoking habit at the time of surgical treatment is a risk factor for poor long-term survival in NBNC-HCC patients. Current smokers tend to have multiple HCCs at a younger age than other patients.
authors.affiliation: Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.
authors.forename: Keita
authors.initials: K
authors.lastname: Kai
authors.affiliation: Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Koga
authors.affiliation: Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.affiliation: Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Kawaguchi
authors.affiliation: Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.
authors.forename: Koutaro
authors.initials: K
authors.lastname: Yamaji
authors.affiliation: Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.
authors.forename: Takao
authors.initials: T
authors.lastname: Ide
authors.affiliation: Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Ueda
authors.affiliation: Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Noshiro
mesh_terms: D000368:Aged; D000437:Alcoholism / Q000150:complications; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery*; D018572:Disease-Free Survival; D005234:Fatty Liver / Q000601:surgery; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D014029:Tobacco Use Disorder / Q000150:complications*; D016896:Treatment Outcome
keywords: Hepatocellular carcinoma; Non-B Non-C; Prognosis; Smoking; Surgery