Bao Xiaodan, Liu Fengqiong, Chen Qing, Chen Lin, Lin Jing, Chen Fa, Wang Jing, Qiu Yu, Shi Bin, Pan Lizhen, Lin Lisong, He Baochang
Department of Epidemiology and Health Statistics, Fujian Provincial Key Laboratory of Environment Factors and Cancer, School of Public Health, Fujian Medical University, Fujian, China.
Key Laboratory of Ministry of Education for Gastrointestinal Cancer, Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fujian, China.
Head Neck. 2020 Aug;42(8):1837-1847. doi: 10.1002/hed.26099. Epub 2020 Feb 7.
To explore the effect of smoking and drinking on survival of patients with oral cancer by comparing the characteristics and survival of nonsmoking and nondrinking (NSND) patients in contrast to smoking and/or drinking (SD) patients.
This prospective study including 1165 patients with oral cancer was conducted in Fujian, China from January 2005 to January 2019. The patients were categorized to two groups, the NSND group and SD group. We compared overall survival and disease-specific survival between the two groups using the Kaplan-Meier method and Cox proportional hazards regression before and after propensity score matching (PSM) to explore the effect of smoking and drinking on the prognosis of patients with oral cancer.
NSND patients accounted for 55.45% (646 patients) of all the patients with oral cancer. SD patients with oral cancer tended to be older and mainly are male (98.46%) and with more advanced disease status. There are trends toward both higher risk of all-cause death (HR = 1.678; 95% CI: 1.086-2.594) and oral cancer specific death (HR = 1.632; 95% CI: 1.044-2.552) in SD patients with oral cancer before PSM. After PSM, the association is still significant, with adjusted HR of 1.897 (95% CI: 1.138-3.165) for all-cause death and adjusted HR of 1.764 (95% CI: 1.043-2.983) for oral cancer-specific death. Additionally, PSM can improve the HR value and result in a stronger association.
Social and clinical characteristics of NSND patients differed from SD patients with oral cancer. SD patients with oral cancer have higher all-cause mortality and oral cancer-specific mortality than NSND patients.
通过比较不吸烟不饮酒（NSND）患者与吸烟和/或饮酒（SD）患者的特征及生存率，探讨吸烟和饮酒对口腔癌患者生存的影响。
2005年1月至2019年1月在中国福建进行了这项前瞻性研究，纳入1165例口腔癌患者。患者被分为两组，即NSND组和SD组。我们在倾向评分匹配（PSM）前后，使用Kaplan-Meier法和Cox比例风险回归比较两组的总生存率和疾病特异性生存率，以探讨吸烟和饮酒对口腔癌患者预后的影响。
NSND患者占所有口腔癌患者的55.45%（646例）。患有口腔癌的SD患者往往年龄较大，主要为男性（98.46%），且疾病分期更晚。在PSM之前，患有口腔癌的SD患者全因死亡风险（HR = 1.678；95%CI：1.086 - 2.594）和口腔癌特异性死亡风险（HR = 1.632；95%CI：1.044 - 2.552）均有升高趋势。PSM后，这种关联仍然显著，全因死亡的调整后HR为1.897（95%CI：1.138 - 3.165），口腔癌特异性死亡的调整后HR为1.764（95%CI：1.043 - 2.983）。此外，PSM可以提高HR值并导致更强的关联。
NSND患者与患有口腔癌的SD患者的社会和临床特征不同。患有口腔癌的SD患者的全因死亡率和口腔癌特异性死亡率高于NSND患者。
