Chest

Chest

Volume 130, Issue 6, December 2006, Pages 1784-1790
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Original Research: Lung Cancer
Smoking Cessation After Diagnosis of Lung Cancer Is Associated With a Beneficial Effect on Performance Status

https://doi.org/10.1016/S0012-3692(15)50902-1Get rights and content

Study objective

To evaluate the impact of smoking history and postdiagnosis smoking cessation on performance status (PS) and survival in patients with lung cancer.

Design

Patients with non-small cell lung cancer (NSCLC) who were referred to our pulmonary laboratory for evaluation for surgical resectability between January and November 2001 were reviewed. We investigated the association between smoking status after diagnosis and survival, as well as the change in PS from the initial status to status at 6 and 12 months after the diagnosis was established.

Results

The records were reviewed for 206 patients, of whom 93 (45%) were current smokers, 15 (7%) were never-smokers, and 98 (48%) were former smokers. Among the 93 smokers, 46 quit and 47 continued smoking after the diagnosis. Disease stage, patient demographics, treatment modalities, and comorbidities were similar between these two groups. While there was no significant association between smoking status after diagnosis and patient survival, those who quit smoking maintained a better PS at 0 to 6 months (odds ratio [OR], 7.09; 95% confidence interval [CI], 1.99 to 25.3; p = 0.002) and at 0 to 12 months (OR, 6.99; 95% CI, 1.76 to 27.7; p = 0.006) than those who continued smoking after the adjustment for disease stage, patient demographics, treatment modalities, and comorbidities.

Conclusion

Patients who quit smoking after the diagnosis of NSCLC maintained a better PS at 6 and 12 months regardless of disease stage, age, race, sex, therapy types, and comorbidities than those who continued to smoke.

Section snippets

Materials and Methods

The study was approved by the Institutional Review Board. The electronic medical records of 206 patients with NSCLC who were referred to our pulmonary function laboratory for evaluation of surgical eligibility between January and November 2001 were reviewed. Studies performed in our pulmonary function laboratory included pulmonary function tests (PFTs), xenon studies, and exercise stress testing, where indicated. The data collected from the medical records included the following: clinical

Results

Two hundred six consecutive patients were included in this historical cohort. The demographic and clinical characteristics of these patients are shown in Table 1. At the time of analysis, 109 patients (52%) had died. The median survival time and survival data by smoking status are shown in Table 2.

The average predicted FEV1 was 70.3 ± 19.6% predicted (range, 25 to 123% predicted). One hundred thirty-two patients (64%) had at least one comorbidity, as follows: 66 patients (32%) had hypertension;

Discussion

Our study suggests that patients who quit smoking after the diagnosis of NSCLC maintained a better PS at 6 and 12 months, regardless of disease stage, age, race, sex, comorbidities, and cancer-related treatment modalities, than those who continued to smoke. Survival differences between the two groups of patients were not statistically different, possibly due to the small number of patients. To date, only a few studies have examined the effect of smoking status on treatment efficacy, toxicity,

Conclusion

Our study specifically addressed the impact of continued smoking on PS following the diagnosis of lung cancer. Smoking cessation after the diagnosis of lung cancer has a beneficial effect on PS. Our results highlight the importance of smoking cessation in lung cancer patients and provide oncologists with additional evidence for making this recommendation.

ACKNOWLEDGMENT

We gratefully thank Leendert Keus, Pulmonary Laboratory Manager, for his invaluable assistance with data collection, and Karen Campbell for her technical support. We also thank Vickie Williams and Linda J. Foot for editing the manuscript.

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    The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.

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    Copyright © 2006 The American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.