Prognosis of smokers following resection of pathological stage I non-small-cell lung carcinoma

Abstract

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. 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. 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. 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.