Shinkichi Takamori1, Mototsugu Shimokawa2, Taichi Matsubara3, Naoki Haratake3, Ryo Toyozawa3, Naoko Miura3, Masafumi Yamaguchi3, Takashi Seto3, Tetsuzo Tagawa4, Tatsuro Okamoto3, Mitsuhiro Takenoyama3, Yoshihiko Maehara5, Masaki Mori4. 1. Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan. takamori@surg2.med.kyushu-u.ac.jp. 2. Department of Biostatistics, Yamaguchi University Graduate School of Medicine, Ube, Japan. 3. Department of Thoracic Oncology, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan. 4. Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan. 5. Department of Surgery, Kyushu Central Hospital of the Mutual Aid Association of Public School Teachers, Fukuoka, Japan.
Abstract
BACKGROUND: The pack-year index, which is calculated by multiplying a smoking period by the number of cigarette packs smoked per day, is frequently used to investigate the risk of developing lung cancer. Notably, however, whether the smoking period or the number of packs per day is more predictive of postoperative prognosis remains unclear in non-small cell lung cancer (NSCLC) patients who receive curative lung resection. PATIENTS AND METHODS: Initial screening included 2055 consecutive lung cancer patients who had underwent curative lung resection between 2000 and 2016 at a single center in Japan. Data from 1134 NSCLC patients with smoking history were ultimately analyzed. Time-dependent areas under the curve (AUCs) were used to compare diagnostic accuracy. RESULTS: On univariate analysis, the number of packs smoked per day was not a significant predictor of disease-free survival (DFS; p = 0.2387) or overall survival (OS; p = 0.1357). On multivariable analysis, smoking period was an independent predictor of DFS and OS (both p < 0.0001). Time-dependent smoking period AUCs were superior to those of number of packs smoked per day. On subgroup analyses, patients with a smoking period ≥ 40 years had significantly shorter DFS and OS than those with a smoking period of < 40 years, independent of sex, clinical stage, and histological type. CONCLUSIONS: Smoking period was a significant prognostic indicator in NSCLC patients who underwent curative lung resection, which should be validated in further prospective and/or multicenter studies with large sample sizes.
BACKGROUND: The pack-year index, which is calculated by multiplying a smoking period by the number of cigarette packs smoked per day, is frequently used to investigate the risk of developing lung cancer. Notably, however, whether the smoking period or the number of packs per day is more predictive of postoperative prognosis remains unclear in non-small cell lung cancer (NSCLC) patients who receive curative lung resection. PATIENTS AND METHODS: Initial screening included 2055 consecutive lung cancerpatients who had underwent curative lung resection between 2000 and 2016 at a single center in Japan. Data from 1134 NSCLCpatients with smoking history were ultimately analyzed. Time-dependent areas under the curve (AUCs) were used to compare diagnostic accuracy. RESULTS: On univariate analysis, the number of packs smoked per day was not a significant predictor of disease-free survival (DFS; p = 0.2387) or overall survival (OS; p = 0.1357). On multivariable analysis, smoking period was an independent predictor of DFS and OS (both p < 0.0001). Time-dependent smoking period AUCs were superior to those of number of packs smoked per day. On subgroup analyses, patients with a smoking period ≥ 40 years had significantly shorter DFS and OS than those with a smoking period of < 40 years, independent of sex, clinical stage, and histological type. CONCLUSIONS: Smoking period was a significant prognostic indicator in NSCLCpatients who underwent curative lung resection, which should be validated in further prospective and/or multicenter studies with large sample sizes.
Entities:
Keywords:
Non-small cell lung cancer; Prognosis; Smoking; Surgery
Authors: David S Ettinger; Wallace Akerley; Gerold Bepler; Matthew G Blum; Andrew Chang; Richard T Cheney; Lucian R Chirieac; Thomas A D'Amico; Todd L Demmy; Apar Kishor P Ganti; Ramaswamy Govindan; Frederic W Grannis; Thierry Jahan; Mohammad Jahanzeb; David H Johnson; Anne Kessinger; Ritsuko Komaki; Feng-Ming Kong; Mark G Kris; Lee M Krug; Quynh-Thu Le; Inga T Lennes; Renato Martins; Janis O'Malley; Raymond U Osarogiagbon; Gregory A Otterson; Jyoti D Patel; Katherine M Pisters; Karen Reckamp; Gregory J Riely; Eric Rohren; George R Simon; Scott J Swanson; Douglas E Wood; Stephen C Yang Journal: J Natl Compr Canc Netw Date: 2010-07 Impact factor: 11.908
Authors: Yelena Y Janjigian; Kevin McDonnell; Mark G Kris; Ronglai Shen; Camelia S Sima; Peter B Bach; Naiyer A Rizvi; Gregory J Riely Journal: Cancer Date: 2010-02-01 Impact factor: 6.860
Authors: T Fujisawa; T Iizasa; Y Saitoh; Y Sekine; S Motohashi; T Yasukawa; K Shibuya; K Hiroshima; H Ohwada Journal: J Clin Oncol Date: 1999-07 Impact factor: 44.544
Authors: James C Yao; Manisha H Shah; Tetsuhide Ito; Catherine Lombard Bohas; Edward M Wolin; Eric Van Cutsem; Timothy J Hobday; Takuji Okusaka; Jaume Capdevila; Elisabeth G E de Vries; Paola Tomassetti; Marianne E Pavel; Sakina Hoosen; Tomas Haas; Jeremie Lincy; David Lebwohl; Kjell Öberg Journal: N Engl J Med Date: 2011-02-10 Impact factor: 91.245
Authors: Lindsey A Torre; Freddie Bray; Rebecca L Siegel; Jacques Ferlay; Joannie Lortet-Tieulent; Ahmedin Jemal Journal: CA Cancer J Clin Date: 2015-02-04 Impact factor: 508.702