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This study evaluated whether smoking duration and malnutrition jointly influence overall survival (OS) in patients with solid tumours, and examined systemic inflammation as a plausible mechanism. Data from INSCOC (29,988 patients) linked smoking exposure and PG-SGA nutritional status with inflammatory biomarkers using regression and survival models.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/combined-impact-of-smoking-duration-and-malnutrition-on-cancer-survival-insights-into-systemic-inflammation/353706/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/combined-impact-of-smoking-duration-and-malnutrition-on-cancer-survival-insights-into-systemic-inflammation/353706.png","ImageObject",300,407,{"name":92,"@type":93},"Asher","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-28","2026-09-22",true,{"@type":102,"interactionType":103,"userInteractionCount":39},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study’s primary goal?","Question",{"text":112,"@type":113},"To assess the joint impact of smoking duration and malnutrition on overall survival in patients with solid tumours, and to explore systemic inflammation as an underlying mechanism.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What dataset and nutritional assessment were used?",{"text":117,"@type":113},"The study used the INSCOC cohort and assessed nutritional status with the Patient-Generated Subjective Global Assessment (PG-SGA), alongside smoking status and haematological indicators.",{"name":119,"@type":110,"acceptedAnswer":120},"How did smoking and malnutrition affect mortality risk?",{"text":121,"@type":113},"Both factors independently increased mortality risk, and the highest risk was observed in patients with both smoking and malnutrition.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},353706,1790163036,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},687197207639,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Journal of Cachexia, Sarcopenia and Muscle  \n ORIGINAL ARTICLE  OPEN ACCESS   \nCombined Impact of Smoking Duration and Malnutrition on Cancer Survival: Insights Into Systemic Inflammation  \nHong Zhao1,2,3 | Bing Yin1,2,3 | Zhe Zhao4 | Xiangrui Li1,2,3 | Changhong Xu5 | Yi Li6 | Zhaoting Bu1,2,3 | Xinyin Chen1,2,3 | Hanping Shi1,2,3,5,6   \n1Department of Gastrointestinal Surgery/Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University,  \nBeijing, China | 2Key Laboratory of Cancer FSMP for State Market Regulation, Beijing, China | 3Laboratory for Clinical Medicine, Capital Medical University, Beijing, China | 4Department of Obstetrics and Gynecology, Beijing Shijitan Hospital, Capital Medical University, Beijing, China | 5Department of Gastrointestinal and Gland Surgery, the First Affiliated Hospital, Guangxi Medical University, Nanning, Guangxi, China | 6The First Affiliated Hospital of Wenzhou Medical University, Wenzhou Medical University, Wenzhou, China  \nCorrespondence: Hanping Shi ([shihp@ccmu.edu.cn](shihp@ccmu.edu.cn))  \nReceived: 4 March 2025 | Revised: 3 September 2025 | Accepted: 4 January 2026  \nKeywords: cancer | inflammation | malnutrition | smoking | survival  \nABSTRACT  \nBackground: Smoking and malnutrition are established risk factors for cancer survival, yet evidence on their combined effects remains limited. This study aimed to investigate the joint impact of smoking duration and malnutrition on overall survival (OS) in patients with solid tumours and to explore the potential underlying mechanism—systemic inflammation.  \nMethods: This study was based on the Investigation of Nutrition Status and Clinical Outcomes in Common Cancers (INSCOC), which enrolled 29 988 patients with solid tumours and collected data on smoking status, nutritional status assessed by the Patient-Generated Subjective Global Assessment (PG-SGA) and haematological indicators. Restricted cubic spline regression, Cox proportional hazards models and logistic regression were used to examine the associations of smoking and malnutrition with OS and their relationships with inflammatory markers.  \nResults: A total of 29 988 patients were included, among whom 7649 were smokers with malnutrition (male: 7095 [92.8%]; female: 554 [7.2%]); their mean age was 60.17 ± 10.57years. Both smoking and malnutrition independently increased mortality risk in patients with solid tumours (HR = 1.24, 95% CI 1.15–1.35, p \u003C 0.001; HR = 1.25, 95% CI 1.17–1.33, p \u003C 0.001), with the highest risk observed in those with both risk factors (HR = 1.46, 95% CI 1.36–1.57, p \u003C 0.001). Smoking duration showed a dose– response association with OS. Specifically, among smokers, every additional 5 years of smoking increased the risk of death by 6%(HR = 1.06, 95% CI 1.04–1.07, p \u003C 0.001) . In patients with malnutrition, every additional 10 years of smoking increased the risk of death by 86%(HR = 1.86, 95% CI 1.55–2.23, p\u003C 0.001). Further analyses showed that, with increasing smoking duration, CRP increased from 3.50 [1.79, 13.60] to 6.00 [2.87, 24.90] mg/L and WBC from 5.70 [4.47, 7.31] to 6.47 [5.10, 8.40] × 109/L (both p \u003C 0.001) . With worsening malnutrition, CRP rose from 3.11 [1.23, 6.28] to 10.00 [3.20, 40.70] mg/L and WBC from 5.70 [4.51, 7.24] to 6.39 [4.84, 8.71] × 109/L (both p \u003C 0.001), indicating that prolonged smoking and aggravated malnutrition were associated with elevated systemic inflammation.  \nConclusions: Smoking and malnutrition are crucial prognostic factors for survival in cancer patients. The results emphasize the critical role of managing smoking duration and improving nutritional status in the care of cancer patients. Clinically, attention should be given to controlling inflammation levels in patients with smoking and malnutrition.  \n\n| Hong Zhao, Bing Yin and Zhe Zhao are co-first authors of this article. |\n| --- |\n| This is an open access article under the terms of the Creative Commons Attribution License, which permits use, ","cbCaifhPDeSsT4Gr","https://ap.wps.com/l/cbCaifhPDeSsT4Gr","pdf",1555268,13,"English","# Introduction\n# Abstract\n## Background\n## Methods\n## Results\n## Conclusions","[{\"question\":\"What was the study’s primary goal?\",\"answer\":\"To assess the joint impact of smoking duration and malnutrition on overall survival in patients with solid tumours, and to explore systemic inflammation as an underlying mechanism.\"},{\"question\":\"What dataset and nutritional assessment were used?\",\"answer\":\"The study used the INSCOC cohort and assessed nutritional status with the Patient-Generated Subjective Global Assessment (PG-SGA), alongside smoking status and haematological indicators.\"},{\"question\":\"How did smoking and malnutrition affect mortality risk?\",\"answer\":\"Both factors independently increased mortality risk, and the highest risk was observed in patients with both smoking and malnutrition.\"}]","Combined Impact of Smoking Duration and Malnutrition on Cancer Survival - Insights Into Systemic Inflammation | PDF",1790106842,33]