Chest
Clinical InvestigationsLUNG CANCERImproved Survival in Never-Smokers vs Current Smokers With Primary Adenocarcinoma of the Lung
Section snippets
Materials and Methods
Patients with lung cancer seeking treatment at the H. Lee Moffitt Cancer Center between 1985 and 2000 filled out a questionnaire developed by the thoracic oncology program, in which detailed smoking information was collected. Hence, demographic data including a detailed smoking history were prospectively collected. All patients who were histopathologically confirmed to have adenocarcinoma (or bronchioloalveolar carcinoma [BAC]) of pulmonary origin were included in this analysis. Survival data
Results
A total of 141 documented never-smokers with primary adenocarcinoma of the lung were registered between 1985 and 2000. Seven of the 141 patients were excluded from the study due to ambiguity of stage assigned at presentation, and 2 patients were excluded after chart review revealed a smoking history. There were 542 current smokers identified. Twenty of the 542 patients were excluded from the study secondary to ambiguity in staging assigned.
The demographic characteristics of both the cohorts are
Discussion
Multiple chemicals in cigarette smoke are presumed to induce carcinogenesis in smokers. However, no such insult exists in never-smokers, suggesting an alternate mechanism of carcinogenesis and therefore a distinct natural history and tumor biology. We performed this analysis to determine whether demographic characteristics and survival would be disparate in the never-smokers vs current smokers with lung adenocarcinoma.
Our studies indicate that never-smoking patients with lung adenocarcinoma
Conclusions
Our data show that never-smokers with adenocarcinoma are predominantly women, present at a higher age, and have improved survival when compared to current smokers. The survival difference may be partly influenced by less comorbidity among never-smokers. We conclude that owing to differences in mechanism of carcinogenesis, demographic factors, tumor behavior, and survival, adenocarcinomas occurring in never-smokers may warrant further investigation as a separate entity. A better understanding of
ACKNOWLEDGMENT
The authors thank Mr. K. G. Rajan for editorial assistance.
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