TY - JOUR
T1 - Prognostic Impact of Smoking Period in Patients with Surgically Resected Non-small Cell Lung Cancer
AU - Takamori, Shinkichi
AU - Shimokawa, Mototsugu
AU - Matsubara, Taichi
AU - Haratake, Naoki
AU - Toyozawa, Ryo
AU - Miura, Naoko
AU - Yamaguchi, Masafumi
AU - Seto, Takashi
AU - Tagawa, Tetsuzo
AU - Okamoto, Tatsuro
AU - Takenoyama, Mitsuhiro
AU - Maehara, Yoshihiko
AU - Mori, Masaki
N1 - Funding Information:
Takashi Seto received grants and personal fees from AstraZeneca, grants and personal fees from Chugai Pharmaceutical, grants and personal fees from Daiichi Sankyo, grants and personal fees from Eli Lilly Japan, grants and personal fees from MSD, grants and personal fees from Nippon Boehringer Ingelheim, grants and personal fees from Novartis Pharma, grants and personal fees from Pfizer Japan, grants and personal fees from Takeda Pharmaceutical, personal fees from Astellas Pharma, personal fees from Bristol-Myers Squibb, personal fees from Kyowa Hakko Kirin, personal fees from Ono Pharmaceutical, personal fees from Taiho Pharmaceutical, personal fees from Thermo Fisher Scientific, grants from Abbvie, grants from Bayer Yakuhin, grants from Kissei Pharmaceutical, grants from LOXO Oncology, grants from Merck Serono, and personal fees from Precision Medicine Asia Co. Ltd., outside the submitted work. Tetsuzo tagawa received grants from Chugai Pharmaceutical and Roche Diagnostics. Masaki Mori received grants from Chugai Pharmaceutical. All the other authors declare no conflicts of interest.
Publisher Copyright:
© 2020, Society of Surgical Oncology.
PY - 2021/2
Y1 - 2021/2
N2 - 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.
AB - 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.
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U2 - 10.1245/s10434-020-08851-6
DO - 10.1245/s10434-020-08851-6
M3 - Article
C2 - 32676867
AN - SCOPUS:85087724815
VL - 28
SP - 685
EP - 694
JO - Annals of Surgical Oncology
JF - Annals of Surgical Oncology
SN - 1068-9265
IS - 2
ER -