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Published in: Annals of Surgical Oncology 2/2021

01-02-2021 | NSCLC | Thoracic Oncology

Prognostic Impact of Smoking Period in Patients with Surgically Resected Non-small Cell Lung Cancer

Authors: Shinkichi Takamori, MD, PhD, Mototsugu Shimokawa, MD, PhD, Taichi Matsubara, MD, PhD, Naoki Haratake, MD, PhD, Ryo Toyozawa, MD, Naoko Miura, MD, PhD, Masafumi Yamaguchi, MD, PhD, Takashi Seto, MD, PhD, Tetsuzo Tagawa, MD, PhD, Tatsuro Okamoto, MD, PhD, Mitsuhiro Takenoyama, MD, PhD, Yoshihiko Maehara, MD, PhD, Masaki Mori, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2021

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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.
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Metadata
Title
Prognostic Impact of Smoking Period in Patients with Surgically Resected Non-small Cell Lung Cancer
Authors
Shinkichi Takamori, MD, PhD
Mototsugu Shimokawa, MD, PhD
Taichi Matsubara, MD, PhD
Naoki Haratake, MD, PhD
Ryo Toyozawa, MD
Naoko Miura, MD, PhD
Masafumi Yamaguchi, MD, PhD
Takashi Seto, MD, PhD
Tetsuzo Tagawa, MD, PhD
Tatsuro Okamoto, MD, PhD
Mitsuhiro Takenoyama, MD, PhD
Yoshihiko Maehara, MD, PhD
Masaki Mori, MD, PhD
Publication date
01-02-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08851-6

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