In a cohort study reported in JAMA network openWang et al. found that patients with non-small cell lung cancer (NSCLC) who quit smoking before their cancer diagnosis had better overall survival than those who were current smokers at diagnosis.
Research details
The study involved NSCLC patients recruited to the Massachusetts General Hospital Boston Lung Cancer Survival Cohort between 1992 and 2022.
Main findings
Of the 5594 NSCLC patients analyzed, 795 (14.2%) were nonsmokers at diagnosis, 3308 (59.1%) were former smokers, and 1491 (26.7%) were current smokers. rice field.
Median overall survival was 58.9 months (95% confidence interval) [CI] 51.9 to 67.4 months for never smokers), 51.2 months (95% CI = 47.7 to 54.6 months) for former smokers and 34.0 months (95% CI = 29.1 to 42.3 months) for current smokers. . In an analysis that adjusted for age, sex, histologic profile, and clinical stage, the hazard ratio for all-cause mortality was 1.26 (95% CI = 1.13 to 1.40, P. < .001 in ex-smokers), 1.68 (95% CI = 1.50 to 1.89, P. < .001) between current smokers and nonsmokers.
Among former smokers, doubling the number of years abstained was associated with a significant increase in survival (HR = 0.96, 95% CI = 0.93 to 0.99, P. = .003), whereas doubling the number of pack years smoked was associated with a non-significant reduction in survival (HR = 1.03, 95% CI = 0.98 to 1.07, P. = .21).
In subgroup analyzes according to clinical stage at diagnosis, smoking history was associated with shorter overall survival in patients diagnosed with early-stage disease (HR = 1.37, P. < .001 for ex-smokers and non-smokers. HR = 1.93, P. < .001, current smokers and nonsmokers) compared with patients diagnosed with stage IIIB to IV disease (HR = 1.19, P. = .01, comparing ex-smokers and never-smokers. HR = 1.43, P. < .001, comparing current smokers with nonsmokers).
The researchers concluded, “In this cohort study of patients with NSCLC, early smoking cessation after lung cancer diagnosis was associated with reduced mortality, and the association between smoking history and overall survival was clinically significant at diagnosis.” May vary by stage.Different treatment regimens and efficacy associated with smoking exposure after diagnosis.Collecting a detailed smoking history may be useful in future epidemiological studies and to improve lung cancer prognosis and treatment selection. It needs to be incorporated into clinical studies.”
David C. Cristiani, MD, MPH, MSof, Harvard School of Environmental Health TH Chan Harvard School of Public Healthis the corresponding author of . JAMA network open article.
Disclosure: This research was supported by a grant from the National Cancer Institute. For full disclosure of study authors, please visit: Jamane Network.com.
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