Effect of smoking on survival from non-small cell lung cancer.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1570-1570
Author(s):  
Vijaya Raj Bhatt ◽  
Fausto R. Loberiza ◽  
Apar Kishor Ganti
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Family History ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Smoking Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Never Smokers ◽  
The Impact

1570 Background: Although a well-established risk factor for lung cancer, the impact of smoking on the survival of non-small cell lung cancer (NSCLC) is not well-known. This study evaluated the effects of tobacco exposure on outcomes from NSCLC. Methods: We performed a retrospective analysis of Veteran’s Affairs Comprehensive Cancer Registry of NSCLC patients diagnosed between 1995 and 2009. Data abstracted included age, gender, family history, stage at diagnosis, histology, tumor grade, smoking history, other exposures, treatment received and overall survival (OS). Smoking status was categorized as never-smoker, past-smoker and current-smoker based on the self-reported history at diagnosis. Multivariate analysis was performed using SAS version 10.2. Results: The study population (n=61,440) comprised predominantly of males (98%), of which Caucasians (81%) formed the majority. The median age at diagnosis within this cohort was 68 years (range: 22-108 years) and median follow-up was 6 months (range: <1 – 161 months). Squamous cell carcinoma (35%) and adenocarcinoma (30%) were the most common histologies. The majority (71%) presented with stage III or IV disease. Positive family history was identified in one-third. Current smokers were diagnosed with NSCLC at a younger age (65 yrs) compared to never-smokers (71 yrs) and past-smokers (72 yrs) (p<0.001). After adjusting for age at diagnosis, grade, histology, family history and treatment, current-smokers (n=34613) [Hazard ratio (HR) 1.059; 95% CI, 1.012-1.108], but not past-smokers (n=23864) (HR 1.008; 95% CI, 0.962-1.056), had worse OS for Stage III and IV NSCLC, compared to never-smokers (n=2963). Smoking status was not prognostic in stage I and II NSCLC. Conclusions: Current smokers were 6 years younger than never-smokers at diagnosis of NSCLC. Although current smoking was associated with worse prognosis, especially in stages III and IV, the impact of smoking status on OS was modest, at least in males. Therefore, primary prevention of smoking cessation is more likely to be meaningful than efforts on smoking cessation after the diagnosis of NSCLC.

scholarly journals Family history of lung cancer in never smokers with non-small-cell lung cancer and its association with tumors harboring EGFR mutations

Lung Cancer ◽  
2013 ◽  
Vol 79 (3) ◽  
pp. 193-197 ◽  
Author(s):  
Elizabeth M. Gaughan ◽  
Sarah K. Cryer ◽  
Beow Y. Yeap ◽  
David M. Jackman ◽  
Daniel B. Costa
Keyword(s):  
Lung Cancer ◽  
Family History ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Small Cell ◽  
Egfr Mutations ◽  
Small Cell Lung ◽  
History Of ◽  
Never Smokers

Smoking cessation counseling in advanced non-small cell lung cancer (aNSCLC).

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e20551-e20551
Author(s):  
Janna Radtchenko ◽  
Bruce A. Feinberg
Keyword(s):  
Lung Cancer ◽  
Smoking Cessation ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Smoking Status ◽  
Small Cell ◽  
Smoking History ◽  
Small Cell Lung ◽  
Smoking Cessation Counseling ◽  
Procedure Codes

e20551 Background: Lung cancer is the leading cause of cancer mortality, with smoking the major risk factor1. Advances in treatment (tx) are lengthening survivorship increasing the importance in smoking cessation among diagnosed pts. Barriers to counseling include: time, skill, patient motivation, prognosis and short survival2. This study analyzed smoking status and cessation counseling in better prognosis aNSCLC patients (pts) defined as those who completed at least two lines of systemic therapy (2L). Methods: Using Inovalon’s MORE2 Registry®claims data for July 2013–2014, pts with aNSCLC identified by ICD-9 codes and treated with chemotherapy (chemo) or targeted therapy (TT; erlotinib, ceritinib, afatinib, or crizotinib) were selected. Pts >18 years of age and treated with 1L therapy within 6 months of diagnosis and who completed 2L were eligible. Pts with small cell lung cancer or secondary malignancies, or pts enrolled in a trial, were ineligible. Smoking history was assessed based on ICD-9 codes (305.1, 649.0, 989.84, V15.82), cessation drug use (bupropion, varenicline, nicotine gum or patches), counseling procedure codes (99406, 99407, G0436, S9453). Results: Of 5,319 pts, 2,198 completed 2L; of those 241 (11%) received 1L TT and 1,957 (89%) 1L chemo. 1L TT had a higher proportion of females (66% vs. 52%, p<0.0001) and a lower smoking rate (33% vs. 58%, p<0.0001) compared to chemo. Cessation rates (counseling or drug) were 9% for 1L TT and 13% for 1L chemo. Conclusions: RWE assessment of smoking incidence and cessation counseling is feasible. Despite methodological limitations one third pts on 1L TT had smoking documentation. Evidence of smoking cessation was present in 12% of pts irrespective of 1L tx choice. Our findings warrant increased focus on smoking cessation in aNSCLC. [Table: see text]

Continued Cigarette Smoking by Patients Receiving Concurrent Chemoradiotherapy for Limited-Stage Small-Cell Lung Cancer Is Associated With Decreased Survival

2003 ◽  
Vol 21 (8) ◽  
pp. 1544-1549 ◽  
Author(s):  
Gregory M.M. Videtic ◽  
Larry W. Stitt ◽  
A. Rashid Dar ◽  
Walter I. Kocha ◽  
Anna T. Tomiak ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Overall Survival ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Smoking Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Limited Stage ◽  
Treatment Interruptions ◽  
The Impact

Purpose: To determine the impact of continued smoking by patients receiving chemotherapy (CHT) and radiotherapy (RT) for limited-stage small-cell lung cancer (LSCLC) on toxicity and survival. Patients and Methods: A retrospective review was carried out on 215 patients with LSCLC treated between 1989 and 1999. Treatment consisted of six cycles of alternating cyclophosphamide, doxorubicin, vincristine and etoposide, cisplatin (EP). Thoracic RT was concurrent with EP (cycle 2 or 3) only. Patients were known smokers, with their smoking status recorded at the start of chemoradiotherapy (CHT/RT). RT interruption during concurrent CHT/RT was used as the marker for treatment toxicity. Results: Of 215 patients, smoking status was recorded for 186 patients (86.5%), with 79 (42%) continuing to smoke and 107 (58%) abstaining during CHT/RT. RT interruptions were recorded in 38 patients (20.5%), with a median duration of 5 days (range, 1 to 18 days). Median survival for former smokers was greater than for continuing smokers (18 v 13.6 months), with 5-year actuarial overall survival of 8.9% versus 4%, respectively (log-rank P = .0017). Proportion of noncancer deaths was comparable between the two cohorts. Continuing smokers did not have a greater incidence of toxicity-related treatment breaks (P = .49), but those who continued to smoke and also experienced a treatment break had the poorest overall survival (median, 13.4 months; log-rank P = .0014). Conclusion: LSCLC patients who continue to smoke during CHT/RT have poorer survival rates than those who do not. Smoking did not have an impact on the rate of treatment interruptions attributed to toxicity.

scholarly journals A5-04: The impact of EGFR mutation and smoking status on non-small-cell lung cancer patients treated with geftinib

2007 ◽  
Vol 2 (8) ◽  
pp. S324 ◽  
Author(s):  
Shinichi Toyooka ◽  
Toshimi Takano ◽  
Takayuki Kosaka ◽  
Shuji Ichihara ◽  
Yoshiro Fujiwara ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cancer Patients ◽  
Cell Lung Cancer ◽  
Egfr Mutation ◽  
Smoking Status ◽  
Small Cell ◽  
Small Cell Lung ◽  
Lung Cancer Patients ◽  
The Impact

scholarly journals Does Sex Influence the Impact That Smoking, Treatment Interruption and Impaired Pulmonary Function Have on Outcomes in Limited Stage Small Cell Lung Cancer Treatment?

2005 ◽  
Vol 12 (5) ◽  
pp. 245-250 ◽  
Author(s):  
Gregory MM Videtic ◽  
Pauline T Truong ◽  
Robert B Ash ◽  
Edward W Yu ◽  
Walter I Kocha ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Smoking Status ◽  
Multivariable Analysis ◽  
Concurrent Chemotherapy ◽  
Small Cell ◽  
Small Cell Lung ◽  
Limited Stage ◽  
The Impact

PURPOSE: To look for survival differences between men and women with limited stage small cell lung cancer (LS-SCLC) by examining stratified variables that impair treatment efficacy.METHODS: A retrospective review of 215 LS-SCLC patients treated from 1989 to 1999 with concurrent chemotherapy-radiotherapy modelled on the 'early-start' thoracic radiotherapy arm of a National Cancer Institute of Canada randomized trial.RESULTS: Of 215 LS-SCLC patients, 126 (58.6%) were men and 89 (41.4%) were women. Smoking status during treatment for 186 patients (86.5%) was: 107 (58%) nonsmoking (NS) (76 [71%] male [M]; 31 [29%] female [F]) and 79 (42%) smoking (S) (36 M [46%]; 43 F [54%]) (continuing-to-smoke F versus M, P=0.001). Fifty-six patients (26%) had radiotherapy interruptions (RTI) during chemotherapy-radiotherapy because of toxicity. Radiotherapy breaks were not associated with sex (P=0.95). Survival by sex and smoking status at two years was: F + NS = 38.7%; F + S = 21.6%; M + NS = 22.9%; and M + S = 9.1% (P=0.0046). Survival by sex and RTI status at two years was: F + no RTI = 32.4%; F + RTI = 23.6%; M + no RTI = 23.0%; and M + RTI = 3.8% (P=0.0025). Diffusion capacity for carbon monoxide (DLCO) was recorded for 86 patients (40%) and median survival by sex and DLCO was F = 16.7 months and M = 12.1 months for a DLCO less than 60%; and for a DLCO 60% or more, F = 15.1 months and M = 15.3 months. First relapses were recorded in 132 cases (61%), with chest failure in men (45%) greater than for women (35%) and cranial failure rates similar between sexes (48%). Upon multivariable analysis, continued smoking was the strongest negative factor affecting survival.CONCLUSIONS: In LS-SCLC, women overall do better than men, with or without a negative variable. The largest quantifiable improvement in survival for women came from smoking cessation, and for men from avoidance of breaks during treatment.

The Impact of Smoking Status on the Behavior and Survival Outcome of Patients With Advanced Non-small Cell Lung Cancer

CHEST Journal ◽  
2004 ◽  
Vol 126 (6) ◽  
pp. 1750-1756 ◽  
Author(s):  
Chee-Keong Toh ◽  
Ee-Hwee Wong ◽  
Wan-Teck Lim ◽  
Swan-Swan Leong ◽  
Kam-Weng Fong ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Smoking Status ◽  
Survival Outcome ◽  
Small Cell ◽  
Small Cell Lung ◽  
The Impact

scholarly journals Polymorphisms of Antigen-Presenting Machinery Genes in Non-Small Cell Lung Cancer: Different Impact on Disease Risk and Clinical Parameters in Smokers and Never-Smokers

2021 ◽  
Vol 12 ◽  
Author(s):  
Andrzej Wiśniewski ◽  
Maciej Sobczyński ◽  
Konrad Pawełczyk ◽  
Irena Porębska ◽  
Monika Jasek ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Small Cell Lung Cancer ◽  
Cell Lung Cancer ◽  
Smoking Status ◽  
Active Form ◽  
Small Cell ◽  
Disease Stage ◽  
Small Cell Lung ◽  
Response To Chemotherapy ◽  
Never Smokers

Lung cancer is strongly associated with cigarette smoking; nevertheless some never-smokers develop cancer. Immune eradication of cancer cells is dependent on polymorphisms of HLA class I molecules and antigen-processing machinery (APM) components. We have already published highly significant associations of single nucleotide polymorphisms (SNPs) of the ERAP1 gene with non-small cell lung cancer (NSCLC) in Chinese, but not in Polish populations. However, the smoking status of participants was not known in the previous study. Here, we compared the distribution of APM polymorphic variants in larger cohorts of Polish patients with NSCLC and controls, stratified according to their smoking status. We found significant but opposite associations in never-smokers and in smokers of all tested SNPs (rs26653, rs2287987, rs30187, and rs27044) but one (rs26618) in ERAP1. No significant associations were seen in other genes. Haplotype analysis indicated that the distribution of many ERAP1/2 haplotypes is opposite, depending on smoking status. Additionally, haplotypic combination of low activity ERAP1 and the lack of an active form of ERAP2 seems to favor the disease in never-smokers. We also revealed interesting associations of some APM polymorphisms with: age at diagnosis (ERAP1 rs26653), disease stage (ERAP1 rs27044, PSMB9 rs17587), overall survival (ERAP1 rs30187), and response to chemotherapy (ERAP1 rs27044). The results presented here may suggest the important role for ERAP1 in the anti-cancer response, which is different in smokers versus never-smokers, depending to some extent on the presence of ERAP2, and affecting NSCLC clinical course.

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