Smoking history and PD-1/PDL-1 pathway blockade: Predicting response to treatment in metastatic cancer.

2019 ◽  
Vol 37 (8_suppl) ◽  
pp. 95-95 ◽  
Author(s):  
Caitlin Marie Sullivan ◽  
Jonathan Lu ◽  
John Ross Kucharczyk ◽  
Diana Vesselinovitch ◽  
Neharika Khurana ◽  
...  
Keyword(s):  
Treatment Response ◽  
Smoking Status ◽  
Metastatic Cancer ◽  
Post Treatment ◽  
Inhibitor Therapy ◽  
Response To Treatment ◽  
Smoking History ◽  
Heavy Smoking ◽  
Never Smokers ◽  
Heavy Smokers

95 Background: Identifying patients who will benefit from immune-checkpoint inhibitor therapy is a challenge as proven predicative indicators remain to be elucidated. High tumor mutational burden (TMB) represents a possible biomarker for response to PD1 blockade such as in nivolumab or pembrolizumab. Genomic analyses have shown that patients with heavy smoking history are more likely to have high TMB. However smoking status alone has not been examined independently in relation to treatment response. We sought to determine whether a relationship existed between smoking history and response to treatment in metastatic non-small cell lung cancer (NSCLC), metastatic renal cell carcinoma (mRCC) and metastatic melanoma (mMelanoma). Methods: A retrospective analysis was conducted of Ochsner Health System patients with mRCC, mMelanoma, and NSCLC receiving a minimum of two cycles of nivolumab or pembrolizumab between 12/2014 and 01/2018. Pre- and post-treatment target lesions were analyzed using RECIST criteria to calculate best response to treatment. Patient demographic information was gathered including age, sex, smoking history, and performance status pre and post treatment. Kaplan-Meier method was used to estimate progression free survival (PFS) and overall survival (OS) outcomes. Results: Heavy smokers (>10 pack-years) had a higher response to immunotherapy than light (< 10 years) and never smokers (p = 0.0500). Heavy smokers with NSCLC treated with immuno-therapy also had significantly improved OS compared to light smokers with NSCLC (p=0.003). mRCC immuno-therapy patients with heavy smoking history showed increased PFS compared to light/never smokers (p=0.026). Conclusions: In summary, in response to PD-1 blockade heavy smokers showed improved survival compared to light and never smokers suggesting smoking history may represent a potential predictor of treatment response to PD-1 inhibitor therapy.[Table: see text]

scholarly journals What differs former, light and heavy smokers? Evidence from a post-conflict setting

2021 ◽  
Vol 21 (1) ◽  
pp. 112-22
Author(s):  
Tatjana Gazibara ◽  
Marija Milic ◽  
Milan Parlic ◽  
Jasmina Stevanovic ◽  
Nebojsa Mitic ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Smoking Status ◽  
Smoking Prevention ◽  
Second Hand Smoke ◽  
Tobacco Prevention ◽  
Conflict Setting ◽  
Heavy Smoking ◽  
Post Conflict ◽  
Former Smokers ◽  
Heavy Smokers

Background: Evidence suggests that people who live in regions affected by the armed conflict are more likely to smoke. Objective: The purpose of this study was to assess factors associated with smoking status in a sample of students in the northern Kosovo province. Materials and methods: A total of 514 students enrolled in University in Kosovska Mitrovica, Kosovo, were recruited be- tween April to June 2015 at Student Public Health Center during mandatory health checks. Participants filled in socio-demo- graphic and behavioral questionnaire and Beck Depression Inventory (BDI). Based on responses about smoking, students were categorized in non-smokers, former smokers, light smokers (1-13 cigarettes/day) and heavy smokers (> 13 cigarettes/ day). Results: Of 514 students, 116 (22.6%) classified themselves as smokers. Higher education level of fathers (Odds ra- tio [OR]=2.89, 95% confidence interval [CI] 1.30-6.44, p=0.009), not living with smokers (OR=0.42, 95%CI 0.15-0.97, p=0.017) and longer exposure to second hand smoke (OR=1.07, 95%CI 1.01-1.13, p=0.036) was associated with former smoking. Studying medical and natural sciences (OR=2.07, 95%CI 1.05-4.18, p=0.040), consuming alcohol (OR=2.98, 95%CI 1.19-10.03, p=0.020), living with smokers (OR=2.88, 95%CI 1.49-5.56, p=0.002), longer exposure to second hand smoke (OR=1.06, 95%CI 1.01-1.11, p=0.019) and having a more intense depressive symptoms (OR=1.08, 95%CI 1.03-1.13, p=0.002) was associated with light smoking. Being male (OR=0.22, 95%CI 0.07-0.41, p=0.001), older (OR=1.47, 95%CI 1.21-1.78, p=0.001), living with smokers (OR=3.78, 95%CI 1.69-8.07, p=0.001), longer daily exposure to second-hand smoke (OR=1.10, 95%CI 1.04-1.16, p=0.001), and having more severe depressive symptoms (OR=1.12, 95%CI 1.07-1.18, p=0.001) were associated with heavy smoking. Conclusion: Smoking prevention and cessation programs should include the entire community, because exposure to en- vironmental second hand smoke may facilitate initiation and more intense smoking. Screening of student smokers for depression should be prioritized in the process of rebuilding the framework for primary and secondary prevention in the post-conflict period. Keywords: Students; smoking; tobacco; prevention.

Smoking and the risk of anal cancer recurrence: The Addenbrookes Hospital experience.

2014 ◽  
Vol 32 (3_suppl) ◽  
pp. 439-439
Author(s):  
Anna Bowzyk Al-Naeeb ◽  
Gill Barnett ◽  
Charles Wilson
Keyword(s):  
High Risk ◽  
Anal Cancer ◽  
Smoking Status ◽  
Cancer Recurrence ◽  
Squamous Carcinoma ◽  
Response To Treatment ◽  
Smoking History ◽  
Risk Category ◽  
High Risk Disease

439 Background: Anal cancer, a tumour induced by the human papilloma virus (HPV) is highly responsive to chemoradiation. Smoking appears to be an important cofactor in its development, possibly through immunomodulatory mechanism and has been reported to have a negative effect on prognosis. Objective is to evaluate the relation between smoking and the outcome in patients receiving radical chemoradiotherapy (50.4 Gy/ 28f with concomitant 5FU/Mitomycin) for squamous carcinoma of the anus. Methods: 109 patients treated with radical intent from January 2009- Feb 2013 were retrospectively analysed. Details of staging, smoking history, HIV status, response to treatment, follow up time and recording of persistent or recurrence were collected. High risk disease (HR) was defined as any T3/T4 disease or TxN2+, standard risk (SR) as T1/2 N0-1. Results: 68 females and 41 males with an age range 38-83 (median 61).Data about smoking status was available in 74 patients: 28 smokers, 8 ex-smokers, and 38 non-smokers. 54/109 (49%) had high risk disease (HR), and the distribution was balanced across the groups. 4 patients were HIV positive. Median follow up time was 23 months. Complete clinical response was achieved in 101/109 (93%), 1 patient died (cause unknown), and 7 had persistent disease. Of these 6 were smokers (2 SR, 3HR, 1 HR and HIV+) 1 was a non-smoker (1 HR). 9 patients developed recurrent disease: 5 smokers (2 SR, 3 HR), 1 ex-smoker (HR), 3 unknown (2HR, 1SR). 11/16 patients who had a local failure were persistent smokers. Using ordinal logistic regression, smoking increases the risk of recurrence with an Odds ratio of 17.4 (p=0.008). Conclusions: This retrospective series suggest that smoking is associated with a higher risk of local recurrence following chemoradiotherapy. One of the hypothesis is that tissue hypoxia may impact on the oxygen dependent effect of chemoradiation. Patients should be encouraged to stop smoking and smoking may need to be considered as a factor defining a higher risk category which may benefit from dose escalation.

Effect of smoking on the efficacy of immune checkpoint inhibitors in advanced cancers: A systematic review and meta-analysis.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14109-e14109
Author(s):  
Chia Ching Lee ◽  
Ivan Weng Keong Tham ◽  
Yu Yang Soon ◽  
Jeremy Chee Seong Tey
Keyword(s):  
Immune Checkpoint ◽  
Immune Checkpoint Inhibitors ◽  
Checkpoint Inhibitors ◽  
Smoking Status ◽  
Meta Analysis ◽  
Random Effect ◽  
Standard Of Care ◽  
Smoking History ◽  
P Value ◽  
Never Smokers

e14109 Background: The association between smoking history and benefit from treatment with immune checkpoint inhibitors (ICIs) was unclear. We performed a meta-analysis to assess the efficacy of ICIs in advanced cancers according to smoking status (never-smokers vs ever-smokers). Methods: We searched MEDLINE and EMBASE for randomized controlled trials (RCTs) comparing immunotherapy with standard-of-care in the treatment of advanced cancers which reported overall survival (OS) as the outcome, stratified by smoking status. We calculated pooled hazard ratios (HRs) and 95% confidence interval (CIs) for OS using random-effect models and assessed the differences in OS between the two estimates (never smoker (vs) ever smoker). using a test of heterogeneity. We also performed prespecified subgroup analyses based on disease site, line of therapy, proportion of never-smokers in the trials and trial conclusion to assess the potential association of oncologic and methodologic factors in effect modification of smoking status with the efficacy of ICIs. Results: We identified ten RCTs on non-small cell lung cancer, head and neck, and urothelial cancers, including 4,245 ever-smokers and 972 never-smokers. The difference in the effects of ICIs on OS between ever-smokers (HR, 0.74; 95% CI, 0.66-0.84) and never-smokers (HR, 0.79; 95% CI, 0.61-1.02) was not statistically significant (interaction P-value = 0.69). There were no significant differences in the effects of ICIs on OS between ever-smokers and never smokers in the pre-specified subgroups. Conclusions: There was no significant association between smoking status and improved survival outcome with ICIs in the treatment of advanced cancers. Smoking status should not be used as a biomarker for guiding treatment with immunotherapy.

scholarly journals Prospective study evaluating dynamic changes of cell-free HPV DNA in locoregional viral-associated oropharyngeal cancer treated with induction chemotherapy and response-adaptive treatment

BMC Cancer ◽  
2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Ari J. Rosenberg ◽  
Evgeny Izumchenko ◽  
Alexander Pearson ◽  
Zhen Gooi ◽  
Elizabeth Blair ◽  
...  
Keyword(s):  
Prospective Study ◽  
Treatment Response ◽  
Induction Chemotherapy ◽  
Oropharyngeal Cancer ◽  
Post Treatment ◽  
Smoking History ◽  
Dynamic Changes ◽  
Hpv Dna ◽  
Adaptive Treatment ◽  
Receive Treatment

Abstract Background Human papillomavirus (HPV)-associated oropharyngeal cancer (OPC) has a favorable prognosis which has led to efforts to de-intensify treatment. Response-adaptive de-escalated treatment is promising, however improved biomarkers are needed. Quantitative cell-free HPV-DNA (cfHPV-DNA) in plasma represents an attractive non-invasive biomarker for grading treatment response and post-treatment surveillance. This prospective study evaluates dynamic changes in cfHPV-DNA during induction therapy, definitive (chemo)radiotherapy, and post-treatment surveillance in the context of risk and response-adaptive treatment for HPV + OPC. Methods Patients with locoregional HPV + OPC are stratified into two cohorts: High risk (HR) (T4, N3, $$\ge$$ ≥ 20 pack-year smoking history (PYH), or non-HPV16 subtype); Low risk (LR) (all other patients). All patients receive induction chemotherapy with three cycles of carboplatin and paclitaxel. LR with ≥ 50% response receive treatment on the single-modality arm (minimally-invasive surgery or radiation alone to 50 Gy). HR with ≥ 50% response or LR with ≥ 30% and < 50% response receive treatment on the intermediate de-escalation arm (chemoradiation to 50 Gy with cisplatin). All other patients receive treatment on the regular dose arm with chemoradiation to 70 Gy with concurrent cisplatin. Plasma cfHPV-DNA is assessed during induction, (chemo)radiation, and post-treatment surveillance. The primary endpoint is correlation of quantitative cfHPV-DNA with radiographic response. Discussion A de-escalation treatment paradigm that reduces toxicity without compromising survival outcomes is urgently needed for HPV + OPC. Response to induction chemotherapy is predictive and prognostic and can select candidates for de-escalated definitive therapy. Assessment of quantitative cfHPV-DNA in the context of response-adaptive treatment of represents a promising reliable and convenient biomarker-driven strategy to guide personalized treatment in HPV + OPC. Trial registration This trial is registered with ClinicalTrials.gov on October 1st, 2020 with Identifier: NCT04572100.

scholarly journals Effects of Smoking on Outcomes of Antivascular Endothelial Growth Factor Therapy in Patients with Neovascular Age-Related Macular Degeneration Smoking and Anti-VEGF Therapy in nAMD

2018 ◽  
Vol 2018 ◽  
pp. 1-7 ◽  
Author(s):  
Hiroyuki Kamao ◽  
Katsutoshi Goto ◽  
Yumi Mito ◽  
Atsushi Miki ◽  
Junichi Kiryu
Keyword(s):  
Growth Factor ◽  
Age Related Macular Degeneration ◽  
Heavy Smoking ◽  
Age Related ◽  
Antivascular Endothelial Growth Factor ◽  
History Of ◽  
Never Smokers ◽  
Endothelial Growth Factor ◽  
Number Of Injections ◽  
Heavy Smokers

Purpose. To evaluate the effect of smoking on the outcome of antivascular endothelial growth factor (VEGF) therapy in patients with neovascular age-related macular degeneration (nAMD). Methods. This retrospective case-control study included 64 eyes in 59 patients with treatment-naïve nAMD. Smoking habits were obtained from hospital records and patient recall. The patients were divided into ever-smokers and never-smokers. The patients were treated with ranibizumab or aflibercept for at least 1 year. Outcome measures were best-corrected visual acuity (BCVA), central retinal thickness (CRT) at the fovea, subfoveal choroidal thickness (SCT), and number of injections received. Results. There were no statistically significant differences in BCVA, CRT, or SCT changes between ever-smokers and never-smokers. The number of injections received was significantly higher in ever-smokers with a history of heavy smokers (never-smokers vs. heavy smokers: 5.3 ± 2.6/year vs. 7.3 ± 2.5/year; P=0.048 and mild smokers vs. heavy smokers: 5.2 ± 2.5/year vs. 7.3 ± 2.5/year; P=0.043). There was no significant difference in the baseline CRT or presence of atrophic retinal pigment epithelium in the fellow eyes of patients with nAMD according to smoking status; however, the baseline CRT in eyes with nAMD was significantly thinner in ever-smokers than in never-smokers (P=0.02). Conclusion. The anti-VEGF therapy was frequently required in nAMD patients with a history of heavy smoking. Heavy smoking could cause poor therapeutic response in nAMD patients.

Making smoking history: temporal changes in support for a future smoking ban and increasing taxes in the general population of Denmark

2021 ◽  
pp. tobaccocontrol-2020-056067
Author(s):  
Cecilie Goltermann Toxværd ◽  
Charlotta Pisinger ◽  
Maja Bülow Lykke ◽  
Cathrine Juel Lau
Keyword(s):  
Policy Making ◽  
Smoking Status ◽  
Public Support ◽  
Temporal Changes ◽  
Smoking History ◽  
Smoking Ban ◽  
Tobacco Taxes ◽  
The World ◽  
Never Smokers ◽  
Almost All

BackgroundAn end date for smoking has been adopted in several countries and is now being discussed by governments all over the world. However, little is known about temporal changes in citizens’ support for a future smoking ban.AimTo examine temporal changes in support for a future smoking ban and for increasing taxes on tobacco in Denmark, and to explore whether these changes differ across sex, age, educational attainment, smoking status and between smokers with/without intention to quit.MethodThe study was based on two waves of ‘The Danish Capital Region Health Survey’ conducted in 2013 and 2017. The pooled study sample included 96 521 citizens aged ≥16 years old.ResultsPublic support for a future smoking ban increased from 30.6% in 2013 to 50.3% in 2017, whereas support for increasing tobacco taxes remained unchanged at 59%. Support for a future smoking ban increased significantly in almost all subgroups from 2013 to 2017: Support among daily smokers increased by 27% between 2013 and 2017. Support among never smokers was almost 2.63 times higher than among smokers in 2013 and increased further in 2017 (OR: 2013=2.63; 2017=5.13).ConclusionThis study indicates a readiness to support a future smoking ban and increasing tobacco taxes. Support for a future smoking ban has increased from 2013 to 2017 among both young people and adults. By 2017, about half of the population supported a future smoking ban and increasing tobacco taxes. Findings may help inform policy-making related to endgame strategies.

Smoking history and adherence to cancer-related recommendations in a primary care setting

2021 ◽  
Author(s):  
Roger J Zoorob ◽  
Maria C Mejia ◽  
Jennifer Matas ◽  
Haijun Wang ◽  
Jason L Salemi ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
Pap Smear ◽  
Task Force ◽  
Smoking Status ◽  
The United States ◽  
Smoking History ◽  
Former Smokers ◽  
Never Smokers ◽  
Primary Care Practices

Abstract Public health prevention efforts have led to overall reductions in mortality from screening-preventable cancers. We explored cancer screening behaviors of smokers, former smokers, and nonsmokers among patients of large primary care practices to discover the relationship between smoking status and previous adherence to the United States Preventive Services Task Force breast, cervical, and colorectal cancer screening recommendations. Our descriptive study of electronic medical record data included 6,029 established primary care patients. Multi-predictor log-binomial regression models yielded prevalence ratios (PRs) and 95% confidence intervals (CIs) to determine associations between smoking status and the likelihood of nonadherence. All models were adjusted for race/ethnicity, age, insurance, primary care specialty, number of comorbidities, and sex. Smoking history was obtained from all participants in January 2020. Current smokers accounted for 4.8%, while 22.7% were former smokers, and 72.5% were never smokers. Current smokers (compared to never smokers) were 63% more likely to be mammogram nonadherent (PR: 1.63, 95% CI: 1.31 to 2.02), 26% more likely to be Pap smear nonadherent (PR: 1.26, 95% CI: 1.04 to 1.53), and 39% more likely to be colonoscopy nonadherent (PR: 1.39, 95% CI: 1.16 to 1.66). Current smokers and former Powered by Editorial Manager and ProduXion Manager from Aries Systems Corporation smokers had on average 2.9 comorbidities while never smokers had on average 2.1 comorbidities. Our findings showed that current smokers experienced significantly lower rates of cancer screening compared to never smokers. Further research is needed to investigate and identify best practices for increasing cancer screening uptake in this population.

Family History of Crohn’s Disease (CD) May Be a Risk Factor for Developing de novo CD following Ileal Pouch Anal Anastomosis (IPAA) for Ulcerative Colitis (UC)

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S150-S150
Author(s):  
H Li ◽  
M Arslan ◽  
Z Fu ◽  
H Lee ◽  
M Mikula
Keyword(s):  
Family History ◽  
De Novo ◽  
Smoking Status ◽  
Smoking History ◽  
Current Smoking Status ◽  
Current Smoking ◽  
History Of ◽  
Former Smokers ◽  
Never Smokers

Abstract Introduction/Objective A subset of patients with an established diagnosis of UC develops signs of CD (de novo CD) following IPAA. While the etiology and risk factors of de novo CD remain largely unknown, preliminary studies have shown controversial results regarding family history of inflammatory bowel disease (IBD) and smoking history. Methods Patients that underwent IPAA for UC, with at least 1 year of follow-up, were identified (n=161; 1996 to 2018). We retrospectively reviewed the electronic medical records. Patients that were diagnosed with de novo CD during the follow-up period were further identified. Smoking history and family history of IBD were evaluated. Chi square test was performed to compare the frequencies. Odds ratio (OR) and 95% confidence intervals (CIs) were estimated by logistic regression model. P&lt;0.05 was considered statistically significant. Results 29 de novo CD were identified. At the time of proctocolectomy, the family history of IBD and smoking history was documented in 152 UC patients including 27 that subsequently developed de novo CD. 23 of 152 had a family history of IBD (12 UC, 9 CD and 2 IBD, NOS). 19/129 (14.7%) UC patients without a family history of any type of IBD, 4/9 (44.4%) with a family history of CD, and 4/12 (33.3%) with a family history of UC developed de novo CD. Patients with a family history of CD were more likely to develop de novo CD post IPAA than those without a family history of any type of IBD (OR 4.63, 95% CI 1.14-18.82, p=0.03). Family history of UC did not correlate with development of de novo CD (OR 2.90; 95% CI 0.79-10.57, p=0.108). At the time of proctocoletomy, 11 were current smokers, 25 were former smokers, and 116 never smoked. In de novo CD group, there were 4/27 (14.8 %) former smokers and 23/27 (85.2 %) never smokers. No de novo CD patient was current smoker. In the UC group that remained as UC following IPAA, 11/125 (8.8%) were current smokers, 21/125 (16.8 %) former smokers, and 93/125 (74.4 %) were never smokers. Current smoking status was not associated with development of de novo CD (p = 0.214). Conclusion Family history of CD may be a risk factor for developing de novo CD following IPAA for UC. Current smoking status was not associated with development of de novo CD following IPAA for UC.

Predictive value of baseline clinicopathological factors in non-small cell lung cancer (NSCLC) patients on checkpoint inhibitors (CPI).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e14119-e14119
Author(s):  
James Newman ◽  
Isabel Ruth Preeshagul ◽  
Kevin M. Sullivan ◽  
Nina Kohn ◽  
Nagashree Seetharamu
Keyword(s):  
Predictive Value ◽  
Checkpoint Inhibitors ◽  
Smoking Status ◽  
Objective Response ◽  
Predictive Biomarkers ◽  
Smoking History ◽  
Exact Test ◽  
Smoking Intensity ◽  
Nsclc Patients ◽  
Heavy Smokers

e14119 Background: Tumor PD-L1 expression and tumor mutational burden currently serve as primary predictive markers for CPI efficacy in NSCLC. However, these markers are imperfect due to tumor heterogeneity, changes over time, and lab variations. These challenges highlight importance of developing dynamic, readily available predictive biomarkers. We evaluated predictive value of pre-treatment Neutrophil-to-Lymphocyte Ratio (NLR), smoking history (SH), body mass index (BMI) and smoking intensity (SI) in NSCLC patients (pts) on CPIs. Methods: Retrospective analysis of NSCLC pts treated with CPIs July 2015 to November 2017. Pt demographics, tumor PD-L1 status positive (pos) or negative (neg) (PD-L1 > 0% or 0% respectively), SH, SI (heavy smokers (HS) or non-heavy smokers (NHS) [ = / > 20 pack-year (PY) and < 20 PY respectively], NLR and BMI high or low based on cutoffs of 5 and 25, respectively were captured. Disease Control Rate (DCR) was defined as objective response or stable disease per RECIST 1.1 at 3 months (m). Median overall survival (OS) and time to progression (TTP) were calculated. Fisher’s exact test and chi-square test were used to compare DCR for each group. Kaplan-Meier curves were used to estimate OS and TTP for each factor. Results: 140 pts were included. NLR was associated with DCR, OS, and TTP. 62/90 (68.9%) pts in the low NLR group and 18/47 (38.3%) in the high NLR group had DCR (p < 0.0006). Median OS for low NLR was 15 m (95% CI: 11.75, 22.25) vs. 5.25 m for high NLR (95% CI: 2.75, 9.75) (p < 0.0005). Median TTP for low NLR was 8 m (95% CI: 6.00, 11.25) vs 3 m for the high (95% CI, 2.00, 4.00) (p < 0.0001). SH was not associated with DCR or survival, but was predictive of TTP. SI was predictive of DCR, but not OS or TTP. 65/100 (65.0%) HS and 15/34 (44.1%) NHS had DCR (p < 0.0320). BMI and PD-L1 (n = 55) were not associated with any outcome. There was association between high BMI and low NLR (P < 0.0381). There were no other associations between factors. Conclusions: NLR < 5 was associated with improvement in all measures of outcome while smoking was associated with some. Neither BMI nor PD-L1 were predictive of any outcome. A score incorporating NLR and smoking status may be beneficial in choosing patients for CPIs.

scholarly journals Smoking and Breast Cancer Recurrence after Breast Conservation Therapy

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Jennifer D. Bishop ◽  
Brigid K. Killelea ◽  
Anees B. Chagpar ◽  
Nina R. Horowitz ◽  
Donald R. Lannin
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
African American Women ◽  
Smoking Status ◽  
Breast Conservation ◽  
Tumor Stage ◽  
Partial Mastectomy ◽  
Smoking History ◽  
Never Smokers

Background. Prior studies have shown earlier recurrence and decreased survival in patients with head and neck cancer who smoked while undergoing radiation therapy. The purpose of the current study was to determine whether smoking status at the time of partial mastectomy and radiation therapy for breast cancer affected recurrence or survival.Method. A single institution retrospective chart review was performed to correlate smoking status with patient demographics, tumor characteristics, and outcomes for patients undergoing partial mastectomy and radiation therapy.Results. There were 624 patients who underwent breast conservation surgery between 2002 and 2010 for whom smoking history and follow-up data were available. Smoking status was associated with race, patient age, and tumor stage, but not with grade, histology, or receptor status. African American women were more likely to be current smokers (22% versus 7%,P<0.001). With a mean follow-up of 45 months, recurrence was significantly higher in current smokers compared to former or never smokers (P=0.039). In a multivariate model adjusted for race and tumor stage, recurrence among current smokers was 6.7 times that of never smokers (CI 2.0–22.4).Conclusions. Although the numbers are small, this study suggests that smoking may negatively influence recurrence rates after partial mastectomy and radiation therapy. A larger study is needed to confirm these observations.

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