38P - Overall survival in non-smokers and quitters compared to smokers who develop lung cancer: Case–control data from routine clinical practice

Date 15 April 2016
Event European Lung Cancer Conference 2016 (ELCC) 2016
Session Poster lunch
Topics Aetiology, epidemiology, screening and prevention
Thoracic malignancies
Basic Scientific Principles
Presenter Martin Faehling
Citation Journal of Thoracic Oncology (2016) 11 (supplement 4): S57-S166. S1556-0864(16)X0004-4
Authors M. Faehling1, B. Schwenk1, R. Eckert2, M. Leschke1, F. Liewald3, M. Geissler4
  • 1Klinik Für Kardiologie Und Pneumologie, Klinikum Esslingen, 73730 - Esslingen/DE
  • 2-, Onkologische Schwerpunktpraxis Esslingen, 73728 - Esslingen/DE
  • 3Klinik Für Gefäß- Und Thoraxchirurgie, Klinikum Esslingen, 73730 - Esslingen/DE
  • 4Klinik Für Onkologie Und Gastroenterologie, Klinikum Esslingen, 73730 - Esslingen/DE

Abstract

Background

An improved survival of smokers who quit smoking at diagnosis of lung cancer has been established in particular for early stages of lung cancer but data from routine clinical practice are scarce. Moreover, apart from studies focusing on lung cancer with an oncogenic driver mutation, the prognosis of never-smokers and long-term non-smokers (“non-smokers”) has not been studied.

Methods

We retrospectively analysed overall survival (OS) in all patients diagnosed with SCLC (171) and NSCLC (713) at our institutions from 2006 to 2014. In a case-control analysis matched for histology, gender, stage, and performance state, we compared non-smokers with quitters at diagnosis of lung cancer and continuing smokers. These analyses were performed for the whole population and for SCLC, squamous-cell carcinoma (SCC), and adenocarcinoma (ADC).

Results

In the case-control population, non-smokers were 3–5 years older at diagnosis of lung cancer than quitters or smokers. Median OS was 13.9 months, which compares favourably with survival in other recent cohorts and clinical studies with similar populations. In localized lung cancer stages I-III, OS of non-smokers (22.2 mo) and continuing smokers (23.0 mo) was similar, but better in quitters (43.0 mo). In stage IV, there was no difference in the whole population, but analysis of histology subgroups revealed a trend towards poorer survival of non-smokers in SCLC and SCC. In ADC, the survival curves showed no difference between quitters and non-smokers until 28 months but then diverged in favour of non-smokers, pointing to two subpopulations which may be driver-mutation positive patients (better survival) and driver-mutation negative patients.

Conclusions

Favourable OS can be reached in a specialized lung cancer centre in routine clinical practice. The better survival of a subgroup of patients with metastasized ADC may be due to patients with driver mutation. Except for metastasized ADC, non-smokers with lung cancer do not have a better prognosis than smokers but develop lung cancer at a later age. The poor survival of non-smokers points to unknown risk factors. In localized disease stages, quitting smoking at diagnosis is associated with markedly improved survival.

Clinical trial identification

N/A.

Legal entity responsible for the study

Klinikum Esslingen

Funding

Klinikum Esslingen

Disclosure

All authors have declared no conflicts of interest.