Published online Jan 7, 2018. doi: 10.3748/wjg.v24.i1.58
Peer-review started: October 27, 2017
First decision: November 21, 2017
Revised: December 2, 2017
Accepted: December 12, 2017
Article in press: December 12, 2017
Published online: January 7, 2018
Processing time: 72 Days and 18.6 Hours
Although cigarette smoking has been recognized as one of the risk factors for hepatocellular carcinoma (HCC), the surgical outcomes and clinicopathological characteristics according to smoking habits of HCC patients remains unclear. We investigate the association between smoking status and surgical outcomes in hepatitis B virus-related HCC (B-HCC) and HCV-related HCC (C-HCC).
We recently analyzed the relationship between smoking status and surgical outcomes in patients with non-B non-C (NBNC)-HCC, and our analysis revealed that smoking habits are significantly correlated with the curatively resected surgical outcomes of NBNC-HCC. We then speculated that if smoking habits truly affect the postoperative prognosis of HCC, smoking habits might also affect the postoperative prognosis of viral-associated HCC patients.
We conducted the present study to investigate the association between smoking habits and surgical outcomes in B-HCC and C-HCC patients who underwent curative surgery, and clarify the clinicopathological features associated with smoking habits in patients with B-HCC or C-HCC.
Cases of the 341 consecutive patients with viral-associated HCC (C-HCC, n = 273; B-HCC, n = 68) who underwent curative surgery for their primary lesion were retrospectively examined. We categorized smoking status at the time of surgery into never, ex- and current smoker and analyzed the clinicopathological features and surgical outcomes, i.e., disease-free survival (DFS), overall survival (OS), and disease-specific survival (DSS).
The multivariate analysis in the C-HCC group revealed that current-smoker status was significantly correlated with both OS and DSS. No significant correlation was observed between current-smoker status and DFS, OS, or DSS in the B-HCC patients of the univariate or multivariate analyses.
Smoking habit is significantly correlated with the overall and disease-specific survivals of patients with C-HCC, and in contrast, the B-HCC patients showed a weak association between smoking status and surgical outcomes.
The results of this study support the hypothesis that smoking-associated HCC is with is high malignant potential. It would be a motivation for further research. We expect future research clarify the mechanism of carcinogenesis of HCC via smoking. Our results also can be expected to provide further motivation for smoking cessation.