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The influence of smoking intensity on the clinicopathologic features and survival of patients with surgically treated non-small cell lung cancer

 Seong Yong Park  ;  Jin Gu Lee  ;  Jieun Kim  ;  Mi Kyung Bae  ;  Chang Young Lee  ;  Dae Joon Kim  ;  Kyung Young Chung 
 LUNG CANCER, Vol.81(3) : 480-486, 2013 
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Adult ; Aged ; Aged, 80 and over ; Carcinoma, Non-Small-Cell Lung/epidemiology* ; Carcinoma, Non-Small-Cell Lung/etiology* ; Carcinoma, Non-Small-Cell Lung/surgery ; Female ; Follow-Up Studies ; Humans ; Lung Neoplasms/epidemiology* ; Lung Neoplasms/etiology* ; Lung Neoplasms/surgery ; Male ; Middle Aged ; Neoplasm Staging ; Retrospective Studies ; Risk Factors ; Smoking/adverse effects* ; Survival Analysis
Lung cancer surgery ; Smoking ; Statistics ; Survival analysis
BACKGROUND: Smoking is a well-known carcinogen for lung cancer. However, whether smoking affects the biological behavior of lung cancer remains uncertain. This study aimed to investigate the influences of smoking intensity on the clinicopathologic characteristics of and survival in non-small cell lung cancer (NSCLC). METHODS: We retrospectively reviewed 2238 consecutive patients who underwent surgical resection for NSCLC between 1990 and 2010. Smoking intensity was defined as pack-years (PY). The patients were divided into three groups according to the median value of smoking intensity (40 PY): group A (never smokers), group B (smoking intensity less than 40 PY) and group C (smoking intensity more than 40 PY). RESULTS: There were 1629 (72.8%) male patients, and the mean age was 61.71 ± 13.17 years. Adenocarcinoma was reported in 1058 (47.3%) patients. The median follow-up period was 30.7 months (range: 0.0-261.7 months). The 5-year overall survivals for groups A, B and C were 60.1%, 51.6% and 43.2%, respectively (p < 0.001). In subset analysis by histology, the 5-year overall survival was significantly different according to smoking intensity in adenocarcinoma (p < 0.001), but there was no difference in the non-adenocarcinoma. In adenocarcinoma, the incidences of vascular invasion (p = 0.028), pleural invasion (p = 0.013) and poor differentiation (p < 0.001) were higher and tumor sizes (p < 0.001) were greater in group C than others. On multivariate analysis, smoking intensity was an adverse risk factor for overall survival in surgically treated adenocarcinoma patients (hazard ratio = 1.008, p = 0.028). CONCLUSION: Smoking intensity was an adverse prognostic factor after surgical resection of adenocarcinoma. Heavy smoking was correlated with poor pathologic characteristics in adenocarcinoma.
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1. College of Medicine (의과대학) > Dept. of Thoracic and Cardiovascular Surgery (흉부외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Dae Joon(김대준)
Park, Seong Yong(박성용) ORCID logo https://orcid.org/0000-0002-5180-3853
Bae, Mi Kyung(배미경)
Lee, Jin Gu(이진구)
Lee, Chang Young(이창영)
Chung, Kyung Young(정경영)
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