Proportion and clinical features of never-smokers with non-small cell lung cancer

Cancer Communications

Chang-Hoon Lee¹  Young Sik Park¹  Jae-Joon Yim¹  Young Whan Kim¹  Jaeyoung Cho¹  Chul-Gyu Yoo¹  Sun Mi Choi¹  Jinwoo Lee¹  Dong-Wan Kim¹  Sang-Min Lee¹  Sung Koo Han¹  Young Tae Kim² 

[1] Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea;Department of Thoracic and Cardiovascular Surgery, Seoul National University Hospital, Seoul, Republic of Korea

关键词: Non-small cell lung carcinoma;    Never-smoker;    Epidermal growth factor receptor;    KRAS;    Prognosis;   

DOI  :  10.1186/s40880-017-0187-6

学科分类：肿瘤学

来源: Springer

【 摘 要 】

The proportion of never-smokers with non-small cell lung cancer (NSCLC) is increasing, but that in Korea has not been well addressed in a large population. We aimed to evaluate the proportion and clinical features of never-smokers with NSCLC in a large single institution. We analyzed clinical data of 1860 consecutive patients who were newly diagnosed with NSCLC between June 2011 and December 2014. Of the 1860 NSCLC patients, 707 (38.0%) were never-smokers. The proportions of women (83.7% vs. 5.6%) and adenocarcinoma (89.8% vs. 44.9%) were higher among never-smokers than among ever-smokers. Significantly more never-smokers were diagnosed at a younger median age (65 vs. 68 years, P < 0.001) and earlier stage (stage I–II, 44.5% vs. 38.9%, P = 0.015) compared with ever-smokers. Epidermal growth factor receptor mutations (57.8% vs. 24.4%, P < 0.001) and anaplastic lymphoma kinase rearrangements (7.8% vs. 2.8%, P < 0.001) were more common in never-smokers, whereas Kirsten rat sarcoma viral oncogene homolog mutations (5.8% vs. 9.6%, P = 0.021) were less frequently encountered in never-smokers than in ever-smokers. Never-smokers showed longer survival after adjusting for the favorable effects of younger age, female sex, adenocarcinoma histology, better performance status, early stage disease, being asymptomatic at diagnosis, received antitumor treatment, and the presence of driver mutations (hazard ratio, 0.624; 95% confidence interval, 0.460–0.848; P = 0.003). More than one-third of the Korean patients with NSCLC were never-smokers. NSCLC in never-smokers had different clinical characteristics and major driver mutations and resulted in longer overall survival compared with NSCLC in ever-smokers.

【 授权许可】

CC BY