Smoking history predicts for increased risk of second primary lung cancer: A comprehensive analysis

Boyle, John M.; Tandberg, Daniel J.; Chino, Junzo; D’Amico, Thomas A.; Ready, Neal; Kelsey, Chris R.

doi:10.1002/cncr.29095

Cited by 45 publications

(37 citation statements)

References 34 publications

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“…A number of studies have investigated the relationship between smoking and outcome of lung cancer patients, but the results are diverse [7,20,21,[31][32][33][34]. The present results clearly supported the conclusion that smoking history can exert a negative influence on RFS and OS.…”

Section: Discussionsupporting

confidence: 85%

“…The relative risk of lung cancer development is estimated to be 10-to 30-fold in longterm smokers when compared with never smokers [5]. For lung cancer patients, smoking history is associated with diagnosis at a later stage, increased operative mortality, higher rate of local recurrence, and worse long-term survival [6,7]. Furthermore, those who quit smoking develop fewer radiation pneumonitis and infections during radiotherapy, and better response to chemotherapy and targeted therapy [8,9].…”

Section: Original Researchmentioning

confidence: 99%

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Former smokers with non‐small‐cell lung cancers: a comprehensive investigation of clinicopathologic characteristics, oncogenic drivers, and prognosis

et al. 2016

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The aim of this present investigation was to evaluate the clinicopathologic characteristics, oncogenic drivers, and prognosis of former smokers with non-smallcell lung cancer (NSCLC), and to compare them with those of the current and never smokers. This investigation was a single-institution retrospective study of 2289 NSCLC patients, who were classified as former, current, or never smokers. A collection was made of the clinicopathological characteristics, spectra of wellidentified driver genes and survival rates. The survival rates were compared using log-rank test, and independent prognostic factors, identified using Cox regression analysis. Of 2289 NSCLC patients, 257 (11.2%) were former smokers; 868 (37.9%), current smokers; and 1164 (50.9%), never smokers. Compared with the current, the former were characterized by older age at diagnosis (64.3y vs. 59.9y; P < 0.001), earlier TNM stage (stage I, 47.9% vs. 39.5%; P = 0.017), fewer solid predominance in adenocarcinomas (16.2% vs. 29.5%; P = 0.005), and more EGFR mutation (33.2% vs. 20.7%; P < 0.001) but less KRAS mutation (6.7% vs. 11.9%, P = 0.041). No statistically significant survival differences were observed between the former and current. However, the light former smokers presented favorable overall survival when compared with the light current and heavy former or current (the light former vs. the heavy former, P = 0.028; the light former vs. the light current, P = 0.048; and the light former vs. the heavy current, P = 0.048). Our findings suggest that the former smokers with NSCLCs can have distinctive clinicopathologic characteristics, oncogenic drivers, and prognosis, and they, especially the light former, can benefit from smoking cessation. Cancer Medicine Open Access 2118

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Section: Discussionsupporting

confidence: 85%

Section: Original Researchmentioning

confidence: 99%

Former smokers with non‐small‐cell lung cancers: a comprehensive investigation of clinicopathologic characteristics, oncogenic drivers, and prognosis

et al. 2016

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“…Prior NSCLC is a known risk factor for developing second primary NSCLC at estimated rates of 1-2% per year with increasing tobacco exposure conferring higher risk 6, 7 . Population-based and institutional studies have demonstrated that survivors of head and neck cancer as well as Hodgkin's lymphoma are also at increased risk of developing new primary lung cancer 8, 9 .…”

Section: Introductionmentioning

confidence: 99%

Non–Small Cell Lung Cancer as a Second Primary Among Patients With Previous Malignancy: Who Is at Risk?

Nelson

Kim

et al. 2017

Clinical Lung Cancer

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Background Patients with prior malignancies may be at increased risk for non-small cell lung cancer (NSCLC). However, the extent of risk is unknown for many cancer types and it is unclear who may benefit from screening. Methods The Surveillance, Epidemiology and End Results dataset from 1992-2012 was used to identify patients with prior malignancies who were diagnosed with NSCLC ≥6 months after their initial cancer. Standardized incidence ratios (SIR) for NSCLC were calculated as a ratio of observed to expected cases adjusted by person-years at risk. Cancers with SIR >1.0 had higher risk for NSCLC than expected. Analyses were stratified by sex, radiation, and histology. Results Among cancer survivors, 32,058 developed NSCLC. Smoking-related (lung, head and neck, bladder) and hematologic malignancies regardless of prior radiation therapy had the highest SIR for NSCLC (range 1.97-4.88). Prior colorectal and renal cancer survivors also had increased SIR for NSCLC (1.16 and 1.21, respectively). Women with previous pancreatic cancer treated with radiation, breast cancer with or without radiation, and those with thyroid cancer demonstrated higher SIR for lung adenocarcinoma. Men with prior irradiated prostate cancer also had elevated SIR (1.08, CI 1.01-1.15) for lung adenocarcinoma. Patients with melanoma, prostate or uterine cancer had lower SIR for NSCLC than expected. Conclusions Smoking-related malignancies had the highest risk for NSCLC. Radiation conferred elevated risk for NSCLC for certain cancers. Melanoma, prostate, uterine cancer survivors were at low risk for NSCLC. These results may help identify high-risk screening candidates in the growing population of cancer survivors.

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“…In addition, patients with early stage NSCLC are prone to developing a second primary NSCLC at a rate of 1–2%/yr. In the future, targeted nodal assessment could potentially allow for subsequent nodal staging of a second ipsilateral lung cancer, an opportunity which is currently not possible if a full lymphadenectomy has previously been performed 24 .…”

Section: Discussionmentioning

confidence: 99%

A novel technique for tumor localization and targeted lymphatic mapping in early-stage lung cancer

Hachey

Digesu

Armstrong

et al. 2017

The Journal of Thoracic and Cardiovascular Surgery

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Objective To investigate safety and feasibility of navigational bronchoscopy (NB)-guided near-infrared (NIR) localization of small, ill-defined lung lesions and sentinel lymph nodes (SLN) for accurate staging in non-small cell lung cancer (NSCLC) patients. Methods Patients with known or suspected stage I NSCLC were enrolled in a prospective pilot trial for lesion localization and SLN mapping via NB-guided NIR marking. Successful localization, SLN detection rates, histopathologic status of SLN vs overall nodes, and concordance to initial clinical stage were measured. Ex vivo confirmation of NIR+ SLNs and adverse events were recorded. Results Twelve patients underwent NB-guided marking with indocyanine green (ICG) of lung lesions ranging in size from 0.4 to 2.2 cm and located 0.1 to 3 cm from the pleural surface. An NIR+ “tattoo” was identified in all cases. Ten patients were diagnosed with NSCLC and 9 SLNs were identified in 8 of the 10 patients, resulting in an 80% SLN detection rate. SLN pathologic status was 100% sensitive and specific for overall nodal status with no false negative results. Despite prior nodal sampling, one patient was found to have metastatic disease in the SLN alone, a 12.5% rate of disease upstaging with NIR SLN mapping. SLN were detectable for up to 3 hours allowing time for obtaining a tissue diagnosis and surgical resection. There were no adverse events associated with NB-labeling or ICG dye itself. Conclusions NB-guided NIR lesion localization and SLN identification was safe and feasible. This minimally invasive image-guided technique may permit the accurate localization and nodal staging of early stage lung cancers.

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Smoking history predicts for increased risk of second primary lung cancer: A comprehensive analysis

Cited by 45 publications

References 34 publications

Former smokers with non‐small‐cell lung cancers: a comprehensive investigation of clinicopathologic characteristics, oncogenic drivers, and prognosis

Former smokers with non‐small‐cell lung cancers: a comprehensive investigation of clinicopathologic characteristics, oncogenic drivers, and prognosis

Non–Small Cell Lung Cancer as a Second Primary Among Patients With Previous Malignancy: Who Is at Risk?

A novel technique for tumor localization and targeted lymphatic mapping in early-stage lung cancer

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