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. 2017 Feb 8;36(1):20.
doi: 10.1186/s40880-017-0187-6.

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

Jaeyoung Cho  1 , Sun Mi Choi  1 , Jinwoo Lee  1 , Chang-Hoon Lee  1 , Sang-Min Lee  1 , Dong-Wan Kim  1 , Jae-Joon Yim  1 , Young Tae Kim  2 , Chul-Gyu Yoo  1 , Young Whan Kim  1 , Sung Koo Han  1 , Young Sik Park  3
Affiliations

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

Jaeyoung Cho et al. Chin J Cancer. .

Abstract

Background: 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.

Methods: We analyzed clinical data of 1860 consecutive patients who were newly diagnosed with NSCLC between June 2011 and December 2014.

Results: 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).

Conclusions: 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.

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

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Figures

Fig. 1
Fig. 1
Frequencies of driver mutations in 1153 patients with lung adenocarcinoma according to smoking status. EGFR epidermal growth factor receptor, KRAS Kirsten rat sarcoma viral oncogene homolog, ALK anaplastic lymphoma kinase. n is the number of patients with lung adenocarcinoma who were tested for each mutation
Fig. 2
Fig. 2
Kaplan-Meier overall survival curves of 1860 patients with non-small cell lung cancer (NSCLC) according to smoking status
See this image and copyright information in PMC

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