International Agency for Research on Cancer (IARC/WHO), Genomic Epidemiology Branch, Lyon, France (M.S., P.B.).
N.N. Blokhin National Medical Research Centre of Oncology, Moscow, Russia (A.M., O.S., D.Z.).
Ann Intern Med. 2021 Sep;174(9):1232-1239. doi: 10.7326/M21-0252. Epub 2021 Jul 27.
Lung cancer is the leading cause of cancer death worldwide, and about one half of patients with lung cancer are active smokers at diagnosis.
To determine whether quitting smoking after diagnosis of lung cancer affects the risk for disease progression and mortality.
Prospective study of patients with non-small cell lung cancer (NSCLC) who were recruited between 2007 and 2016 and followed annually through 2020.
N.N. Blokhin National Medical Research Center of Oncology and City Clinical Oncological Hospital No. 1, Moscow, Russia.
517 current smokers who were diagnosed with early-stage (IA-IIIA) NSCLC.
Probabilities of overall survival, progression-free survival, and lung cancerspecific mortality and hazard ratios (HRs) for all-cause and cancer-specific mortality.
During an average of 7 years of follow-up, 327 (63.2%) deaths, 273 (52.8%) cancer-specific deaths, and 172 (33.7%) cases of tumor progression (local recurrence or metastasis) were recorded. The adjusted median overall survival time was 21.6 months higher among patients who had quit smoking than those who continued smoking (6.6 vs. 4.8 years, respectively; = 0.001). Higher 5-year overall survival (60.6% vs. 48.6%; = 0.001) and progression-free survival (54.4% vs. 43.8%; = 0.004) were observed among patients who quit than those who continued smoking. After adjustments, smoking cessation remained associated with decreased risk for all-cause mortality (HR, 0.67 [95% CI, 0.53 to 0.85]), cancer-specific mortality (HR, 0.75 [CI, 0.58 to 0.98]), and disease progression (HR, 0.70 [CI, 0.56 to 0.89]). Similar effects were observed among mild to moderate and heavy smokers and patients with earlier and later cancer stages.
Exposure measurements were based on self-reported questionnaires.
Smoking cessation after diagnosis materially improved overall and progression-free survival among current smokers with early-stage lung cancer.
International Agency for Research on Cancer.
肺癌是全球癌症死亡的主要原因，约有一半的肺癌患者在诊断时仍为活跃吸烟者。
确定肺癌诊断后戒烟是否会影响疾病进展和死亡率。
对 2007 年至 2016 年间招募并在 2020 年前每年随访的非小细胞肺癌（NSCLC）患者进行前瞻性研究。
俄罗斯莫斯科 N.N.布赫金国家肿瘤医学研究中心和城市临床肿瘤医院 1 号。
517 名诊断为早期（IA-IIIA）非小细胞肺癌的当前吸烟者。
总生存率、无进展生存率、肺癌特异性死亡率以及全因死亡率和癌症特异性死亡率的危险比（HR）。
在平均 7 年的随访期间，记录了 327 例（63.2%）死亡、273 例（52.8%）肺癌特异性死亡和 172 例（33.7%）肿瘤进展（局部复发或转移）病例。与继续吸烟者相比，戒烟者的中位总生存时间调整后延长了 6.6 个月（分别为 6.6 岁和 4.8 岁；= 0.001）。与继续吸烟者相比，戒烟者的 5 年总生存率（60.6%对 48.6%；= 0.001）和无进展生存率（54.4%对 43.8%；= 0.004）更高。调整后，戒烟与全因死亡率（HR，0.67 [95%CI，0.53 至 0.85]）、癌症特异性死亡率（HR，0.75 [CI，0.58 至 0.98]）和疾病进展（HR，0.70 [CI，0.56 至 0.89]）的风险降低相关。在轻度至中度和重度吸烟者以及早期和晚期癌症患者中，也观察到了类似的效果。
暴露测量基于自我报告的问卷。
肺癌诊断后戒烟可显著改善早期肺癌患者的总生存率和无进展生存率。
国际癌症研究机构。
