A study of patients who were smokers at the time of early-stage non-small cell lung cancer (NSCLC) diagnosis revealed possible links to improved survival outcomes with smoking cessation in this population. The study results were reported in the journal Annals of Internal Medicine.
This prospective, observational study was conducted at the N.N. Blokhin National Medical Research Center of Oncology and City Clinical Oncological Hospital No. 1 of Moscow, Russia. It included patients with early-stage NSCLC (stages I, II, or IIIA). The researchers assessed overall survival (OS), progression-free survival (PFS), and all-cause and lung cancer-specific mortality patterns in patients who quit smoking after the NSCLC diagnosis. Smoking status was based on patient self-reporting.
Follow-up occurred for an average of 7 years. A total of 517 patients who were smokers were evaluated, with 220 having quit smoking after diagnosis and 297 continuing to smoke. A total of 8 patients who had quit smoking reportedly had begun smoking by later time points, and they were included in analysis in the group of patients who quit smoking. Most patients (71.3%) in the group who quit smoking did so prior to receiving their first treatment.
At follow-up, 63.2% of patients had died, and 52.8% of patients had experienced cancer-specific deaths. Approximately one-third (33.7%) of patients had tumor progression. The adjusted median OS duration was higher by 21.6 months for patients who had quit smoking, compared with those who had continued smoking; the median OS times were 6.6 years and 4.8 years, respectively (P =.001).
The 5-year OS rates were 60.6% for patients who quit smoking and 48.6% for those who continued smoking (P =.001). The 5-year PFS rates were 54.4% for patients who quit and 43.8% for those who continued smoking (P =.004).
A lower all-cause mortality was associated with smoking cessation (hazard ratio [HR], 0.67 [95% CI, 0.53-0.85]). Smoking cessation was also linked to lower risks of cancer-specific mortality (HR, 0.75 [95% CI, 0.58-0.98]) and progressive disease (HR, 0.70 [95% CI, 0.56-0.89]), defined as tumor recurrence or death.
“In summary, our prospective study provides extensive evidence that quitting smoking after a diagnosis of early-stage NSCLC can have an important effect on subsequent mortality and progression-free survival,” the researchers concluded.
Sheikh M, Mukeriya A, Shangina O, Brennan P, Zaridze D. Postdiagnosis smoking cessation and reduced risk for lung cancer progression and mortality: a prospective cohort study. Ann Intern Med. Published July 27, 2021. doi:10.7326/M21-0252