Prognosis of smokers following resection of pathological stage I non-small-cell lung carcinoma.
OBJECTIVE
Many patients who undergo surgery for non small-cell lung cancer (NSCLC) have a smoking habit, which is a risk factor for NSCLC and chronic obstructive pulmonary disease (COPD). In addition, both smoking habits and COPD has been revealed to be a prognostic indicator following surgery for NSCLC. We conducted a multicenter retrospective observational study to address these issues.


METHODS
Cigarette smoking and airway obstruction severity were chosen as variables to assess overall and disease-specific survival of 169 patients with pathological stage I primary NSCLC (119 stage IA, 50 stage IB) who underwent resection in 2000.


RESULTS
The overall 5-year survival rates were 91% for patients who had never smoked (n=66), 88% for ex-smokers (n=36), and 72% for current smokers (n=67) (P=0.04). The never-smoked group had higher ratios for the factors female, pathological IA, adenocarcinoma, and favorable airway obstruction. In a nested analysis of smokers (ex-smokers and current smokers), smoking status and age were independent factors in a multivariate analysis of disease-specific survival, whereas the degree of airway obstruction was not significant.


CONCLUSIONS
For smokers who underwent resection of p-stage I NSCLC, current smoking was an unfavorable prognostic factor in an analysis containing the degree of airway obstruction as a variable.
Sawabata
Noriyoshi
N
Department of Cardio-Thoracic Surgery, Dokkyo Medical University School of Medicine, 880 Kitakobayashi Mibu Tochigi 321-0293, Japan. sawabata@dokkyomed.ac.jp
Miyoshi
Shinichiro
S
Matsumura
Akihide
A
Ohta
Mitsunori
M
Maeda
Hajime
H
Sueki
Hirofumi
H
Hayakawa
Masanobu
M
Okumura
Meinoshin
M
Sawa
Yoshiki
Y
D000230:Adenocarcinoma / Q000209:etiology / Q000601:surgery*; D000368:Aged; D002289:Carcinoma, Non-Small-Cell Lung / Q000209:etiology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011013:Pneumonectomy; D016016:Proportional Hazards Models; D029424:Pulmonary Disease, Chronic Obstructive / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects*; D013997:Time Factors; D016896:Treatment Outcome