Journal of Chest Surgery

The Korean Society for Thoracic and Cardiovascular Surgery (대한심장혈관흉부외과학회)
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Prognostic Significance of Cigarette Smoking in Association with Histologic Subtypes of Resected Lung Adenocarcinoma

  • Yi, Jung Hoon (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Dong-A University College of Medicine) ;
  • Choi, Pil Jo (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Dong-A University College of Medicine) ;
  • Jeong, Sang Seok (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Dong-A University College of Medicine) ;
  • Bang, Jung Hee (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Dong-A University College of Medicine) ;
  • Jeong, Jae Hwa (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Dong-A University College of Medicine) ;
  • Cho, Joo Hyun (Department of Thoracic and Cardiovascular Surgery, Dong-A University Hospital, Dong-A University College of Medicine)
  • Received : 2018.11.19
  • Accepted : 2019.01.16
  • Published : 2019.10.05
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Abstract

Background: Smokers with lung adenocarcinoma have a worse prognosis than those who have never smoked; the reasons for this are unclear. We aimed to elucidate the impact of smoking on patients' prognosis and the association between smoking and clinicopathologic factors, particularly histologic subtypes. Methods: We reviewed the records of 233 patients with pathologic stage T1-4N0-2M0 lung adenocarcinomas who underwent surgery between January 2004 and July 2015. The histologic subtypes of tumors were reassessed according to the 2015 World Health Organization classification. Results: In total, 114 patients had a history of smoking. The overall survival probabilities differed between never-smokers and ever-smokers (80.8% and 65.1%, respectively; p=0.003). In multivariate analyses, the predominant histologic subtype was an independent poor prognostic factor. Smoking history and tumor size >3 cm were independent predictors of solid or micropapillary (SOL/MIP)-predominance in the logistic regression analysis. Smoking quantity (pack-years) in patients with SOL/MIP-predominant tumors was greater than in those with lepidic-predominant tumors (p=0.000). However, there was no significant difference in smoking quantity between patients with SOL/MIP-predominant tumors and those whose tumors had non-predominant SOL/MIP components (p=0.150). Conclusion: Smoking was found to be closely associated with SOL/MIP-predominance in lung adenocarcinoma. Greater smoking quantity was related to the presence of a SOL/MIP component.

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References

  1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015;136:E359-86. https://doi.org/10.1002/ijc.29210
  2. Alberg AJ, Brock MV, Samet JM. Epidemiology of lung cancer: looking to the future. J Clin Oncol 2005;23:3175-85. https://doi.org/10.1200/JCO.2005.10.462
  3. Sica G, Yoshizawa A, Sima CS, et al. A grading system of lung adenocarcinomas based on histologic pattern is predictive of disease recurrence in stage I tumors. Am J Surg Pathol 2010;34:1155-62. https://doi.org/10.1097/PAS.0b013e3181e4ee32
  4. Hanagiri T, Sugio K, Mizukami M, et al. Significance of smoking as a postoperative prognostic factor in patients with non-small cell lung cancer. J Thorac Oncol 2008;3:1127-32. https://doi.org/10.1097/JTO.0b013e318186fafb
  5. Wakelee HA, Chang ET, Gomez SL, et al. Lung cancer incidence in never smokers. J Clin Oncol 2007;25:472-8. https://doi.org/10.1200/JCO.2006.07.2983
  6. Sakao Y, Miyamoto H, Oh S, et al. The impact of cigarette smoking on prognosis in small adenocarcinomas of the lung: the association between histologic subtype and smoking status. J Thorac Oncol 2008;3:958-62. https://doi.org/10.1097/JTO.0b013e31818396e0
  7. Tseng CH, Chiang CJ, Tseng JS, et al. EGFR mutation, smoking, and gender in advanced lung adenocarcinoma. Oncotarget 2017;8:98384-93. https://doi.org/10.18632/oncotarget.21842
  8. Gazdar AF, Thun MJ. Lung cancer, smoke exposure, and sex. J Clin Oncol 2007;25:469-71. https://doi.org/10.1200/JCO.2006.09.4623
  9. Cha YK, Lee HY, Ahn MJ, et al. The impact of smoking status on radiologic tumor progression patterns and response to epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors in lung adenocarcinoma with activating EGFR mutations. J Thorac Dis 2016;8:3175-86. https://doi.org/10.21037/jtd.2016.11.25
  10. Alfieri RR, Galetti M, Tramonti S, et al. Metabolism of the EGFR tyrosin kinase inhibitor gefitinib by cytochrome P450 1A1 enzyme in EGFR-wild type non small cell lung cancer cell lines. Mol Cancer 2011;10:143. https://doi.org/10.1186/1476-4598-10-143
  11. Filosto S, Khan EM, Tognon E, et al. EGF receptor exposed to oxidative stress acquires abnormal phosphorylation and aberrant activated conformation that impairs canonical dimerization. PLoS One 2011;6:e23240. https://doi.org/10.1371/journal.pone.0023240
  12. Filosto S, Baston DS, Chung S, Becker CR, Goldkorn T. Src mediates cigarette smoke-induced resistance to tyrosine kinase inhibitors in NSCLC cells. Mol Cancer Ther 2013;12:1579-90. https://doi.org/10.1158/1535-7163.MCT-12-1029
  13. Eguchi T, Kadota K, Park BJ, Travis WD, Jones DR, Adusumilli PS. The new IASLC-ATS-ERS lung adenocarcinoma classification: what the surgeon should know. Semin Thorac Cardiovasc Surg 2014;26:210-22. https://doi.org/10.1053/j.semtcvs.2014.09.002
  14. Bracci PM, Sison J, Hansen H, et al. Cigarette smoking associated with lung adenocarcinoma in situ in a large case-control study (SFBALCS). J Thorac Oncol 2012;7:1352-60. https://doi.org/10.1097/JTO.0b013e31825aba47
  15. Lappi-Blanco E, Makinen JM, Lehtonen S, et al. Mucin-1 correlates with survival, smoking status, and growth patterns in lung adenocarcinoma. Tumour Biol 2016;37:13811-20. https://doi.org/10.1007/s13277-016-5269-6
  16. Rokutan-Kurata M, Yoshizawa A, Sumiyoshi S, et al. Lung adenocarcinoma with MUC4 expression is associated with smoking status, HER2 protein expression, and poor prognosis: clinicopathologic analysis of 338 cases. Clin Lung Cancer 2017;18:e273-81. https://doi.org/10.1016/j.cllc.2016.11.013
  17. Zhao ZR, To KF, Mok TS, Ng CS. Is there significance in identification of non-predominant micropapillary or solid components in early-stage lung adenocarcinoma? Interact Cardiovasc Thorac Surg 2017;24:121-5. https://doi.org/10.1093/icvts/ivw283
  18. Nitadori J, Bograd AJ, Kadota K, et al. Impact of micropapillary histologic subtype in selecting limited resection vs lobectomy for lung adenocarcinoma of 2cm or smaller. J Natl Cancer Inst 2013;105:1212-20. https://doi.org/10.1093/jnci/djt166
  19. Yeh YC, Nitadori J, Kadota K, et al. Using frozen section to identify histological patterns in stage I lung adenocarcinoma of $\leq$3 cm: accuracy and interobserver agreement. Histopathology 2015;66:922-38. https://doi.org/10.1111/his.12468
  20. Roh MS, Lee JI, Choi PJ, Hong YS. Relationship between micropapillary component and micrometastasis in the regional lymph nodes of patients with stage I lung adenocarcinoma. Histopathology 2004;45:580-6. https://doi.org/10.1111/j.1365-2559.2004.01953.x
  21. Cha MJ, Lee HY, Lee KS, et al. Micropapillary and solid subtypes of invasive lung adenocarcinoma: clinical predictors of histopathology and outcome. J Thorac Cardiovasc Surg 2014;147:921-8. https://doi.org/10.1016/j.jtcvs.2013.09.045

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