Ann Surg Treat Res.  2023 Oct;105(4):179-187. 10.4174/astr.2023.105.4.179.

Association between preoperative modifiable lifestyle factors and mortality after cancer surgery: a population-based cohort study in South Korea

• Oh TK
• Song IA

• KMID: 2546780
• DOI: http://doi.org/10.4174/astr.2023.105.4.179

Abstract

Purpose
We aimed to examine whether preoperative lifestyle factors are associated with mortality after cancer surgery.
Methods
This study used data from the National Health Insurance Service database in South Korea. We included all adult patients who underwent major cancer surgery between January 1, 2016, and December 31, 2018. Three lifestyle factors were evaluated preoperatively: smoking status, alcohol consumption, and physical activity.
Results
A total of 48,557 patients who underwent major cancer surgery were included in the final analysis. In the multivariable logistic regression modeling, current smokers showed 1.40-fold higher odds of 90-day mortality after cancer surgery (odds ratio, 1.40; 95% confidence interval, 1.14–1.71; P = 0.001) than never smokers. However, alcohol consumption and physical activity were not associated with 90-day mortality after cancer surgery. In the multivariable Cox regression modeling, current smokers showed 1.25-fold higher odds of 1-year mortality after cancer surgery (hazard ratio, 1.25; 95% confidence interval, 1.13–1.38; P < 0.001) than never smokers. However, alcohol consumption and physical activity were not associated with 1-year mortality after cancer surgery.
Conclusion
In conclusion, current smoking was associated with worse short- and long-term survival outcomes in South Korea, though preoperative alcohol consumption and physical activity levels were not associated with mortality after cancer surgery.

Keyword

Cohort studies; General surgery; Mortality; Neoplasms

Figure

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  Fig. 1 Flow chart depicting the patient selection process.

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  Fig. 2 Survival plots derived from the multivariable Cox regression model according to smoking status.

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