ST. LOUIS — Continuing to smoke after surgical treatment for lung cancer has a strong detrimental effect on overall survival, according to a new veterans’ study.
The report in the journal Chest points out that smoking at the time of surgical treatment for lung cancer is known to increase the risk for perioperative morbidity and mortality. What has been unclear is the prevalence of persistent smoking in the post-operative period and how that affects long-term oncologic outcomes, according to researchers from the VA St. Louis Healthcare System and Washington University School of Medicine.1
In response, the study team set out to determine the relationship between persistent smoking and long-term outcomes in early-stage lung cancer following surgical treatment?
Their retrospective cohort study involved a VHA dataset of patients with clinical stage I non-small cell lung cancer (NSCLC) undergoing surgical treatment between 2006 and 2016. Persistent smoking was defined as continuing to smoke one year after surgery; that information was used to describe the relationship between persistent smoking and disease-free survival and overall survival.
Of the 7,489 patients undergoing surgical treatment for clinical stage I NSCLC, 60.9% were smoking at the time of surgery and 58.0% continued to smoke at one year after surgery, according to the authors. Among the 39.1% of patients who were not smoking at the time of surgical treatment, 19.6% relapsed and were smoking at one year after surgery, they added.
Results indicated that persistent smoking at one year after surgery was associated with significantly shorter overall survival (adjusted hazard ration [aHR], 1.291; 95% CI, 1.197-1.392; p<0.001) but was not associated with inferior disease-free survival (aHR, 0.989; 95% CI, 0.884-1.106; P=0.84).
“Persistent smoking following surgery for stage I NSCLC is common and is associated with inferior overall survival,” the researchers concluded. “Providers should continue to assess smoking habits in the post-operative period, given its disproportionate impact on long-term outcomes after potentially curative treatment for early-stage lung cancer.”
- Heiden BT, Eaton DB Jr, Chang SH, Yan Y, et. al. The impact of persistent smoking after surgery on long-term outcomes following stage I non-small cell lung cancer resection. Chest. 2021 Dec 14:S0012-3692(21)05082-0. doi: 10.1016/j.chest.2021.12.634. Epub ahead of print. PMID: 34919892.