The prognostic impact of cigarette smoking on patients with non-small cell lung cancer.
BACKGROUND
The purposes of this study are to investigate the association between cigarette smoking and clinicopathological characteristics of patients with non-small cell lung cancer (NSCLC) and to evaluate its significance as a predictor of recurrence after resection.


METHODS
A total of 2295 consecutive patients with NSCLC underwent complete resection with systematic node dissection between August 1992 and December 2006 at the National Cancer Center Hospital East.


RESULTS
A statistically significant difference in the 5-year overall survival rate was observed between never and ever smokers in patients with stage I (92% and 76%, respectively, p < 0.001) NSCLC, whereas no difference was observed in stage II (57% and 52%, respectively, p = 0.739) and stage III (30% and 33%, respectively, p = 0.897). In patients with stage I NSCLC, 5-year recurrence-free proportions (RFPs) for never and ever smokers were 89% and 80%, respectively (p < 0.001). In contrast, the 5-year RFPs for never smokers were lower than those for ever smokers in stage II (44% and 60%, respectively, p = 0.049) and stage III (17% and 31%, respectively, p = 0.004). In stage I patients, significant difference in 5-year RFP was observed between never and ever smokers (89% and 83%, respectively) in patients with adenocarcinoma, but not in patients with nonadenocarcinoma (82% and 76%, respectively).


CONCLUSIONS
Smoking history showed different impact on postoperative recurrence in patients with NSCLC between stage I and stages II and III, and depending on histology in stage I patients. Disease stages should be considered while evaluating smoking history as a predictor of recurrence.
Department of Thoracic Oncology, National Cancer Center Hospital East, 6-5-1 Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
Ryo
R
Maeda
Junji
J
Yoshida
Genichiro
G
Ishii
Tomoyuki
T
Hishida
Mitsuyo
M
Nishimura
Kanji
K
Nagai
D000230:Adenocarcinoma / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002289:Carcinoma, Non-Small-Cell Lung / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000209:etiology / Q000473:pathology* / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*; D015996:Survival Rate; D055815:Young Adult