Smoking may be a risk factor for pulmonary metastasis of colorectal cancer. - GreenMedInfo Summary

AIM: The hepatic microenvironment, which may include chronic inflammation and fibrosis, is considered to contribute to the pathogenesis of liver metastases of colorectal cancer. A similar mechanism is anticipated in pulmonary metastases, although no reports are available. Smoking causes pulmonary inflammation and fibrosis. Thus, we hypothesized that smokers would be especially affected by pulmonary metastases of colorectal cancer. In this study, we attempted to clarify the impact of smoking on pulmonary metastasis of colorectal cancer.

METHOD: Between September 2005 and December 2010, we reviewed 567 patients with pathological stage I, II, or III colorectal cancer, whose clinicopathological background included a preoperative smoking history, Brinkman index from medical records. We analyzed their impact on pulmonary metastasis-free survival using Cox's proportional hazard model.

RESULTS: Pulmonary metastases occurred in 39 (6.9%) patients. The smoking histories revealed 355 never smokers, 119 former smokers, and 93 current smokers among the subjects. Multivariate analysis revealed that current smoker (HR = 2.72, 95% CI = 1.18-6.25; p = 0.02) was independent risk factors for pulmonary metastases.

CONCLUSION: Smoking may be a risk factor for pulmonary metastasis of colorectal cancer. Cessation of smoking should be recommended to prevent pulmonary metastasis, although further basic and clinical studies are required. This article is protected by copyright. All rights reserved.