Non-small cell lung cancer in ever-smokers vs never-smokers.

IF 7 1区医学 Q1 MEDICINE, GENERAL & INTERNAL

BMC Medicine Pub Date : 2025-01-05 DOI:10.1186/s12916-024-03844-8

Jeremy R Burt, Naim Qaqish, Greg Stoddard, Amani Jridi, Parker Sage Anderson, Lacey Woods, Anna Newman, Malorie R Carter, Reham Ellessy, Jordan Chamberlin, Ismail Kabakus

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引用次数: 0

Abstract

Background: Lung cancer is a leading cause of cancer-related mortality. Non-small cell lung cancer (NSCLC) comprises 85% of cases with rising incidence among never-smokers (NS). This study seeks to compare clinical, imaging, pathology, and outcomes between NS and ever-smokers (S) NSCLC patients to identify significant differences if any.

Methods: Retrospective cohort study of 155 NSCLC patients (88 S and 67 NS). The main predictor was smoking. Clinical, imaging, and pathology findings were evaluated at initial biopsy for staging. The primary outcome was all-cause mortality, and the secondary outcome was 12-month progression-free survival.

Results: Imaging: NS and S had similar nodule size (0.81), calcification (> 0.99), and invasion of adjacent structures (> 0.99) (p values). NS slightly trended to more commonly involve the RLL vs S the RUL (p = 0.11). NS had higher numbers of extrathoracic metastases at initial biopsy for staging (p = 0.055).

Pathology: NS more commonly had adenocarcinoma compared to S, who had equal numbers of adenocarcinoma and squamous cell carcinoma (p = 0.001). Rates of lymphovascular and pleural invasion were similar (p = 0.84 and 0.28). Initial staging: NS were more often initially diagnosed with stage IV disease (p = 0.046), positive nodal disease (p = 0.002), and metastatic disease (p = 0.004).

Outcomes: S had a non-significant trend toward worse 12-month progression-free survival (rate ratio = 1.31, p = 0.31; HR = 1.33, p = 0.28). NS and S had similar 1-year all-cause mortality (HR = 1.06, p = 0.90). S had nearly double the risk of all-cause mortality in 5 years (HR = 1.73, p = 0.056) and 10 years (HR = 1.77, p = 0.02). Median survival was 6.6 years for NS and 3.9 years for S, with NS surviving 2.7 years longer on average (p = 0.045).

Conclusions: CT nodule features were similar in NS and S. NS more often had metastatic adenopathy, distant metastases, and stage IV disease at initial biopsy. Despite similar 12-month progression-free survival and 1-year all-cause mortality, S had nearly double the risk of mortality in the first 5 and 10 years post-diagnosis.

Trial registration: Retrospectively registered.

查看原文本刊更多论文

非小细胞肺癌在吸烟者和不吸烟者中的发病率。

背景：肺癌是癌症相关死亡的主要原因。非小细胞肺癌（NSCLC）占85%的病例，在不吸烟者（NS）中发病率不断上升。本研究旨在比较非吸烟者和非吸烟者(S) NSCLC患者的临床、影像学、病理和预后，以确定是否存在显著差异。方法：对155例NSCLC患者（88例S， 67例NS）进行回顾性队列研究。主要的预测因素是吸烟。临床、影像学和病理结果在初始活检时进行分期评估。主要终点是全因死亡率，次要终点是12个月无进展生存期。结果：影像学：NS与S结节大小相近（0.81）、钙化（> 0.99）、侵犯邻近结构（> 0.99）（p值）。NS更常涉及RLL，而S更常涉及RUL （p = 0.11）。NS在初始活检分期中有较高的胸外转移数（p = 0.055）。病理：NS比S更常发生腺癌，S的腺癌和鳞状细胞癌数量相等（p = 0.001）。淋巴血管和胸膜浸润率相似（p = 0.84和0.28）。初始分期：NS更常被诊断为IV期疾病（p = 0.046）、阳性淋巴结疾病（p = 0.002）和转移性疾病（p = 0.004）。结果：S有较差的12个月无进展生存的无显著趋势(比率= 1.31,p = 0.31；HR = 1.33, p = 0.28)。NS和S的1年全因死亡率相似（HR = 1.06, p = 0.90）。5年（HR = 1.73, p = 0.056）和10年（HR = 1.77, p = 0.02）全因死亡风险几乎翻倍。NS组和S组的中位生存期分别为6.6年和3.9年，NS组的平均生存期延长2.7年（p = 0.045）。结论：NS和s的CT结节特征相似，NS在初始活检时更多出现转移性腺病、远处转移和IV期疾病。尽管12个月的无进展生存期和1年的全因死亡率相似，但S在诊断后的前5年和10年的死亡率几乎是前者的两倍。试验注册：回顾性注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

BMC Medicine 医学-医学：内科

CiteScore

13.10

自引率

1.10%

发文量

435

审稿时长

4-8 weeks

期刊介绍： BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.