Prediction of a New Smoking-Dependent Risk Score for Postsurgical Gastric Cancer-Specific Mortality: The Fiesta Study
35 Pages Posted: 19 Sep 2018More...
We did post hoc analysis of the Fujian prospective investigation of cancer (FIESTA) database, aiming to identify smoking-dependent risk factors that differentially associated with gastric cancer-specific mortality, and further construct a smoking-dependent scoring system for risk assessment. Patients with gastric cancer received radical gastrectomy between 2000 and 2010, with the follow-up ending in 2015. 2779 patients had data on smoking status, including 2223 smokers and 556 never-smokers. Risk estimates were expressed as hazard ratio (HR) with 95% confidence interval (CI). The median follow-up time was 45.55 months. Smoking was not associated with postsurgical survival differences, whereas risk profiles differed between smokers and never-smokers. Particularly, the presence of the metabolic syndrome was significantly associated with increased gastric cancer-specific mortality in smokers (HR (95% CI), p: 2.73 (1.53-4.89), <0.001), but not in never-smokers. Based on significant factors of either smokers or never-smokers, we built a risk score, with 1 unit increment associating with 10% reduced risk of gastric cancer-specific mortality (HR (95% CI), p: 0.90 (0.88-0.91), <0.001). Our findings indicate there is a diverse risk profile between smokers and never-smokers and an additive interaction between smoking and the metabolic syndrome, and importantly we developed a scoring system with a strong predictive capability.
Funding: This study was financially supported by the Joint Funds for the Innovation of Science and Technology of Fujian Province (Grant No. 2017Y9090 and 2017Y9082), the Natural Science Foundation of Fujian Province (Grant No. 2018Y0024). The funder of this study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding authors had full access to all the data in the study and had final responsibility for the decision to submit for publication.
Declaration of Interest: The authors declare that they have no competing interests.
Ethical Approval: The conduct of this study was approved by the ethics committee of Fujian Provincial Cancer Hospital, and all patients signed informed consent.
Keywords: gastric cancer; smoking; the metabolic syndrome; risk score; prognosis
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