Impact of smoking habit on surgical outcomes in non-B non-C patients with curative resection for hepatocellular carcinoma

doi:10.3748/wjg.v23.i8.1397

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World Journal of Gastroenterology

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1007-9327

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World J Gastroenterol. Feb 28, 2017; 23(8): 1397-1405
Published online Feb 28, 2017. doi: 10.3748/wjg.v23.i8.1397

Impact of smoking habit on surgical outcomes in non-B non-C patients with curative resection for hepatocellular carcinoma

Keita Kai, Hiroki Koga, Shinichi Aishima, Atsushi Kawaguchi, Koutaro Yamaji, Takao Ide, Junji Ueda, Hirokazu Noshiro

Keita Kai, Shinichi Aishima, Department of Pathology, Saga University Hospital, Saga 849-8501, Japan

Hiroki Koga, Koutaro Yamaji, Takao Ide, Junji Ueda, Hirokazu Noshiro, Departments of Surgery, Saga University Hospital, Saga 849-8501, Japan

Shinichi Aishima, Koutaro Yamaji, Pathology and Microbiology, Saga University Hospital, Saga 849-8501, Japan

Atsushi Kawaguchi, Center for Comprehensive Community Medicine, Saga University Faculty of Medicine, Saga 849-8501, Japan

Author contributions: Kai K the main author of this article, designed the study, conducted the data collection, and contributed to the statistical analyses; Koga H contributed to the data correction and statistical analyses; Aishima S performed the pathological work and reviewed the manuscript; Kawaguchi A supervised the statistical analyses; Yamaji K, Ide T and Ueda J contributed to the data collection; Noshiro H contributed to the data collection and reviewed the manuscript; all authors have read and approved the final manuscript.

Institutional review board statement: The protocol of this study was reviewed and approved by the Ethics Committee of the Faculty of Medicine at Saga University.

Informed consent statement: Informed consent for the use of resected tissue and medical information was obtained from all patients.

Conflict-of-interest statement: The authors declare that they have no conflicts of interest.

Data sharing statement: The clinical dataset is available from the corresponding author at email: kaikeit@cc.saga-u.ac.jp. Participant consent for data sharing was not obtained, but the presented data are anonymized and the risk of identification is low.

Correspondence to: Dr. Keita Kai, MD, Department of Pathology, Saga University Hospital, Nabeshima 5-1-1, Saga City, Saga 849-8501, Japan. kaikeit@cc.saga-u.ac.jp

Telephone: +81-952-343264 Fax: +81-952-342055

Received: November 27, 2016
Peer-review started: November 28, 2016
First decision: December 19, 2016
Revised: December 31, 2016
Accepted: January 11, 2017
Article in press: January 11, 2017
Published online: February 28, 2017
Processing time: 90 Days and 22.1 Hours

Abstract

AIM

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).

CONCLUSION

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.

Keywords: Hepatocellular carcinoma; Non-B Non-C; Smoking; Surgery; Prognosis

Core tip: We retrospectively analyzed the surgical outcomes and clinicopathological characteristics according to smoking habits in consecutive 83 cases with non-B non-C hepatocellular carcinoma (NBNC-HCC) patients who underwent curative surgical treatment for the primary lesion. Current smoking status was strongly correlated with both overall survival and disease-specific survival by multivariate analyses. Subset analyses revealed that current smokers tended to have multiple HCCs at a younger age than other patients. To our knowledge, this is the first report regarding surgical outcomes of NBNC-HCC patients in relation to their smoking status.