Persistent smoking following surgery for early-stage lung cancer hurts survival

For stage I non-small cell lung cancer (NSCLC) patients who underwent surgery, persistent smoking is detrimental to overall survival, a study has found.

The retrospective cohort study used data from the Veterans Health Administration (VHA) and included patients with clinical stage I NSCLC who received surgical treatment. Researchers evaluated the effect of persistent smoking (defined as continued smoking 1 year after surgery) on disease-free survival and overall survival.

A total of 7,489 patients were included in the analysis. Of these, 4,562 (60.9 percent) patients were smoking at the time of surgery and 2,648 (58.0 percent) continued to smoke through 1 year after the procedure. Among 2,927 (39.1 percent) patients who were not smoking at the time of surgical treatment, 573 (19.6 percent) relapsed and resumed smoking within the 1 year follow-up.

Multivariable Cox regression analysis revealed that persistent smoking through 1 year after the surgery was associated with significantly shorter overall survival (adjusted hazard ratio [aHR], 1.291, 95 percent confidence interval [CI], 1.197–1.392; p<0.001). On the other hand, persistent smoking had a null effect on disease-free survival (aHR, 0.989, 95 percent CI, 0.884–1.106; p=0.84).

In light of the findings, healthcare providers are encouraged to continue to assess the smoking habits of patients in the postoperative period, given its disproportionate impact on long-term outcomes following potentially curative treatment for early-stage lung cancer.