Skip Navigation
Skip to contents

JLC : Journal of Liver Cancer

OPEN ACCESS
SEARCH
Search

Articles

Page Path
HOME > J Liver Cancer > Accepted Articles > Article
Original Article Heavy Smoking Increases Early Mortality Risk in Patients with Hepatocellular Carcinoma after Curative Treatment
Jaejun Lee1,2orcid , Jong Young Choi1,2orcid , Soon Kyu Lee1,3orcid

DOI: https://doi.org/10.17998/jlc.2024.06.02 [Accepted]
Published online: June 7, 2024
1The Catholic University Liver Research Center, Department of Biomedicine & Health Sciences, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
2Division of Hepatology, Department of Internal Medicine, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
3Division of Hepatology, Department of Internal Medicine, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
Corresponding author:  Soon Kyu Lee,
Email: blackiqq@catholic.ac.kr
Received: 24 April 2024   • Revised: 17 May 2024   • Accepted: 2 June 2024
  • 142 Views
  • 13 Download
  • 0 Crossref
  • 0 Scopus

Background
Although cigarette smoking has been associated with an increased risk of hepatocellular carcinoma (HCC), its association with HCC mortality remains underexplored. We aimed to evaluate the effect of smoking on early mortality in HCC patients following curative treatment.
Methods
Data from the Korean Primary Liver Cancer Registry were examined for HCC patients who underwent liver resection or radiofrequency ablation between 2015 and 2018. Smoking cumulative dose was assessed in pack-years. The primary outcome was the 3-year overall survival (OS).
Results
Among 1924 patients, 161 were classified as heavy smokers (≥ 40 pack-years). Heavy smokers exhibited a lower 3-year survival rate (77.1 %) than nonsmokers (83.3%), with a significant difference observed in the 3-year OS (p = 0.016). The assessment of smoking packyears in relation to 3-year OS revealed a dose-dependent pattern, with the hazard ratio exceeding 1.0 at 20 pack-years and continuing to rise until 40 pack-years, reaching peak at 1.21 (95% confidence interval: 1.01, 1.45). Multivariate Cox-regression analysis revealed heavy smoking, age ≥ 60 y, underlying cirrhosis, tumor size > 3 cm, vascular invasion, and Child-Pugh class B/C as risk factors for 3-year OS. Subgroup analyses of patients with a tumor size < 3 cm, absence of vascular invasion, and meeting the Milan criteria also showed inferior outcomes for heavy smokers in all three subgroups.
Conclusion
Heavy smoking, defined as a history of > 40 pack-years, was linked to poorer 3-year survival outcomes in HCC patients undergoing curative treatments, underscoring the importance of smoking cessation in this population.


JLC : Journal of Liver Cancer