Impact of persistence of smoking on recurrence after early stage lung surgery

Abstract

Introduction: Almost 90%of all lung cancers are related to smoking cigarette. Due to the detrimental effect of smoking on lung health, there is not enough data on cancer recurrence of postoperative continuation of smoking. In present study, the effect of persistence of smoking on cancer recurrence after potentially curable early stage lung cancer surgery is investigated.

Methods: Between January 2012-May 2013, patients who had undergone curative intent surgery for stage I non-small cell lung cancer (NSCLC) were retrospectively recorded. Patients demographics, pre- and post-operative smoking status, locoregional recurrence and distant metastasis were analyzed.

Results: Of all the 100 patients, 83 were male with the mean age was 60. Forty-six had been diagnosed as squamous cell carcinoma, 54 as adenocarcinoma. Preoperatively, 73 patients were current smoker whereas 15 had never smoked. The mean cigarette smoking of ever smokers were 45±20 (10-120) pack/year. Follow-up duration was 40±4 (32-49 months). Local relapse or distant metastasis occurred in 10 patients. In statistical analysis, age, gender, pathologic diagnosis, cumulative smoking dose and preoperative smoking status were not found to be correlated with relapse (P>0.05). Among all patients, postoperative persistence of smoking were found to be related with local relapse or metastasis (P=0.002). Similarly, among the pre-operative current smokers, relapse risk had increased significantly in patients who continued smoking (P=0.011).

Conclusion: Patients who remain smoking after lung cancer surgery have a significant risk of tumor relapse or metastasis. Patients should be encouraged to quit smoking and should be referred to smoking cessation programs.