Impact of smoking amount on clinicopathological features and survival in non-small cell lung cancer
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RESEARCH ARTICLE
Open Access
Impact of smoking amount on clinicopathological features and survival in non-small cell lung cancer Woo Ho Ban1, Chang Dong Yeo1, Solji Han2, Hye Seon Kang3, Chan Kwon Park4, Ju Sang Kim5, Jin Woo Kim6, Seung Joon Kim7,8, Sang Haak Lee1,8 and Sung Kyoung Kim9*
Abstract Background: Screening for early detection of lung cancer has been performed in high-risk individuals with smoking history. However, researches on the distribution, clinical characteristics, and prognosis of these high-risk individuals in an actual cohort are lacking. Thus, the objective of this study was to retrospectively review characteristics and prognosis of patients with smoking history in an actual lung cancer cohort. Methods: The present study used the lung cancer cohort of the Catholic Medical Centers at the Catholic University of Korea from 2014 to 2017. Patients with non-small cell lung cancer were enrolled. They were categorized into high and low-risk groups based on their smoking history using the national lung screening trial guideline. Distribution, clinical characteristics, and survival data of each group were estimated. Results: Of 439 patients, 223 (50.8%) patients were in the high-risk group. Patients in the high-risk group had unfavorable clinical characteristics and tumor biologic features. Overall survival of the high-risk group was significantly shorter than that of the low-risk group with both early (I, II) and advanced stages (III, IV). In multivariate analysis, heavy smoking remained one of the most important poor clinical prognostic factors in patients with lung cancer. It showed a dose-dependent relationship with patients’ survival. Conclusions: High-risk individuals had poor clinical outcomes. Patients’ prognosis seemed to be deteriorated as smoking amount increased. Therefore, active screening and clinical attention are needed for high-risk individuals. Keywords: Non-small cell lung cancer, Cigarette smoking, Screening
Background Although the therapeutic paradigm of lung cancer has changed drastically due to the appearance of target and immunotherapy, advanced lung cancer still has high mortality rate and poor prognosis [1]. In addition, because treatment cost for lung cancer is enormous, economic burden has been one of major social problems * Correspondence: [email protected] 9 Division of Pulmonary, Critical Care and Sleep Medicine, Department of Internal Medicine, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea Full list of author information is available at the end of the article
[2]. Therefore, several countries have been trying to provide national screening program for early detection of lung cancer for many years. The most representative one is the National Lung Screening Trial (NLST) in the United States (US). It has been conducting low-dose computed tomography (LDCT) for high risk individuals annually for 3 years, showing an increase of early-stage lung cancers diagnosed and 20% of relative reduction in mortality from lung c
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