National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing, 100021, China.
Lanzhou University Second Hospital, Lanzhou, China.
BMC Cancer. 2024 Sep 16;24(1):1149. doi: 10.1186/s12885-024-12873-8.
This multi-center cohort study aimed to investigate whether sex and prediagnosis lifestyle affect the prognosis of gastric cancer.
Patients with gastric cancer were from four gastric cancer cohorts of the National Cancer Center of China, The First Hospital of Lanzhou University, Lanzhou University Second Hospital, and Gansu Provincial Cancer Hospital. Prediagnosis lifestyle factors in our study included body mass index (BMI) at diagnosis, usual BMI, weight loss, the history of Helicobacter pylori (Hp) infection, and the status of smoking and drinking.
Four gastric cancer cohorts with 29,779 gastric cancer patients were included. In total patients, female patients had a better prognosis than male patients (HR = 0.938, 95%CI: 0.881-0.999, P = 0.046). For prediagnosis lifestyle factors, BMI at diagnosis, usual BMI and the amount of smoking were statistically associated with the prognosis of gastric cancer patients. Female patients with smoking history had a poorer survival than non-smoking females (HR = 0.782, 95%CI: 0.616-0.993, P = 0.044). Tobacco consumption > 40 cigarettes per day (HR = 1.182, 95%CI: 1.035-1.350, P = 0.013) was independent adverse prognostic factors in male patients. Obesity paradox was observed only in male patients (BMI < 18.5, HR = 1.145, 95%CI: 1.019-1.286, P = 0.023; BMI: 23-27.4, HR = 0.875, 95%CI: 0.824-0.930, P < 0.001; BMI ≥ 27.5, HR = 0.807, 95%CI: 0.735-0.886, P < 0.001).
Sex and some prediagnosis lifestyle factors, including BMI at diagnosis, usual BMI and the amount of smoking, were associated with the prognosis of gastric cancer.
本多中心队列研究旨在探讨性别和诊断前生活方式是否影响胃癌的预后。
本研究的胃癌患者来自中国国家癌症中心的四个胃癌队列、兰州大学第一医院、兰州大学第二医院和甘肃省肿瘤医院。我们研究中的诊断前生活方式因素包括诊断时的体重指数（BMI）、常用 BMI、体重减轻、幽门螺杆菌（Hp）感染史以及吸烟和饮酒状况。
共纳入来自四个胃癌队列的 29779 例胃癌患者。在所有患者中，女性患者的预后优于男性患者（HR=0.938，95%CI：0.881-0.999，P=0.046）。对于诊断前的生活方式因素，诊断时的 BMI、常用 BMI 和吸烟量与胃癌患者的预后有统计学关联。有吸烟史的女性患者的生存状况不如不吸烟的女性（HR=0.782，95%CI：0.616-0.993，P=0.044）。每天吸烟超过 40 支（HR=1.182，95%CI：1.035-1.350，P=0.013）是男性患者独立的预后不良因素。仅在男性患者中观察到肥胖悖论（BMI<18.5，HR=1.145，95%CI：1.019-1.286，P=0.023；BMI：23-27.4，HR=0.875，95%CI：0.824-0.930，P<0.001；BMI≥27.5，HR=0.807，95%CI：0.735-0.886，P<0.001）。
性别和一些诊断前的生活方式因素，包括诊断时的 BMI、常用 BMI 和吸烟量，与胃癌的预后有关。
