Author of

• 20154

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  P1.05 - Early Stage NSCLC (ID 691)

  • Event: WCLC 2017
  • Type: Poster Session with Presenters Present
  • Track: Early Stage NSCLC
  • Presentations: 1
  • Moderators:
  • Coordinates: 10/16/2017, 09:30 - 16:00, Exhibit Hall (Hall B + C)

  • 24659

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    P1.05-022d - Lung Cancer in the Innocent Isn't so Innocent (ID 9516)

    09:30 - 09:30  |  Author(s): D. Raymond
    • Abstract

    Background:
    Do never-smokers who develop non–small-cell lung cancer catch a break as innocent bystanders? This study seeks to understand differences in presentation and outcome after resection of lung cancer in never-smokers vs. smokers.
    
    Method:
    From 2006 to 2013, 652 patients underwent lung resection for clinical stage I-III (p I-II or yp I-II) non–small-cell lung cancer (NSCLC)—584 smokers (90%) and 68 never-smokers. Propensity matching yielded comparable pairs of smokers and never-smokers to assess cancer recurrence, overall survival, and recurrence-free survival.
    
    Result:
    Never-smokers presented with somewhat more advanced disease than smokers (59% pT2 vs. 48%, 34% pN1 or pN2 vs. 27%), were more likely to have had preoperative chemotherapy or radiotherapy (26% vs. 17%), and more often were female (66% vs. 45%) and of Asian descent (10% vs. 0.34%). Among matched patients (including for cancer stage), 5-year freedom from cancer recurrence was 57% vs. 49% (Figure) in never-smokers vs. smokers. However, not surprisingly, non-cancer death was lower in never-smokers than smokers (6.3% vs. 16% at 5 years; Figure). Thus, when this competing risk of death without recurrence is accounted for, the proportion of never-smokers experiencing recurrence was 40% vs. 37% for smokers, and recurrence-free survival was 54% vs. 46%.Figure 1
    
    
    
    Conclusion:
    Because disease presentation and response to therapy are unexpectedly and surprisingly similar in never-smokers and smokers, the effect of lung cancer on survival is magnified in never-smokers by fewer non–cancer-related deaths. Moreover, since never-smokers present with fewer comorbidities and singular disease, they are optimal candidates for the most aggressive therapies and tightest long-term surveillance.