Department of Thoracic Surgery, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital & Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China (Sichuan Cancer Hospital), Chengdu, Sichuan, China.
Department of Thoracic Surgery I, Third Affiliated Hospital of Kunming Medical University (Yunnan Cancer Hospital, Yunnan Cancer Center), Kunming, Yunnan, China.
BMJ Open Gastroenterol. 2024 Aug 28;11(1):e001452. doi: 10.1136/bmjgast-2024-001452.
Oesophageal squamous cell carcinoma (OSCC) poses a considerable health burden, particularly in regions such as East Asia. This study aims to investigate the long-term outcomes of OSCC patients who are smokers and drinkers.
In this retrospective analysis, data from Sichuan Cancer Hospital and Institute Esophageal Cancer Case Management Database between January 2010 and December 2017 were examined. Patients were categorised into different groups based on their smoking and alcohol consumption history: None, Smoker, Non-Smoker, Smoke-Only, Drinker, Non-Drinker, Drinker-Only, and Both. Survival outcomes were compared between the groups using Kaplan-Meier analysis and propensity score matching (PSM). The primary outcome was overall survival (OS), measured from surgery to death or last follow-up in April 2022.
The OS median was 45.4 months for all patients after oesophagectomy. Smokers had a significantly lower median OS of 36.6 months compared with Non-Smokers with 66.2 months (p<0.001). Similarly, Drinkers had a lower median OS of 34.4 months compared with Non-Drinkers with 52.0 months (p<0.001). PSM analysis confirmed the significant differences in OS between Smokers and Non-Smokers (p=0.002) and between Drinkers and Non-Drinkers (p=0.002). Subgroup analyses showed no significant differences in OS between Group Another and Group Both, Group Smoker-Only and Group Drinker-Only, and Group Drinker-Only and Group Both. (figure 4) CONCLUSION: Smoking and drinking were associated with significantly reduced OS in patients. However, no significant differences were found between the subgroups of patients who only smoked, only drank, or engaged in both habits.
食管鳞状细胞癌（ESCC）在东亚等地区给人们带来了沉重的健康负担。本研究旨在探讨吸烟和饮酒的 ESCC 患者的长期预后。
本回顾性分析采用四川癌症医院和研究所食管癌病例管理数据库的数据，纳入 2010 年 1 月至 2017 年 12 月期间的患者。根据患者的吸烟和饮酒史将其分为不同组别：无、吸烟、非吸烟、仅吸烟、饮酒、非饮酒、仅饮酒和同时吸烟饮酒。使用 Kaplan-Meier 分析和倾向评分匹配（PSM）比较各组之间的生存结局。主要结局为自手术至死亡或截至 2022 年 4 月的最后一次随访时的总生存（OS）。
所有接受食管切除术的患者 OS 中位数为 45.4 个月。与非吸烟患者的 66.2 个月相比，吸烟者的 OS 中位数显著降低至 36.6 个月（p<0.001）。同样，与非饮酒患者的 52.0 个月相比，饮酒者的 OS 中位数显著降低至 34.4 个月（p<0.001）。PSM 分析证实了吸烟者与非吸烟者（p=0.002）和饮酒者与非饮酒者（p=0.002）之间 OS 存在显著差异。亚组分析显示，在 OS 方面，Group Another 和 Group Both、Group Smoker-Only 和 Group Drinker-Only 以及 Group Drinker-Only 和 Group Both 之间无显著差异（图 4）。
吸烟和饮酒与患者的 OS 显著降低相关。然而，仅吸烟、仅饮酒或同时存在两种习惯的患者亚组之间未发现显著差异。
