Impact of smoking on patients with stage III colon cancer: Results from Cancer and Leukemia Group B 89803 Journal Article


Authors: McCleary, N. J.; Niedzwiecki, D.; Hollis, D.; Saltz, L. B.; Schaefer, P.; Whittom, R.; Hantel, A.; Benson, A.; Goldberg, R.; Meyerhardt, J. A.
Article Title: Impact of smoking on patients with stage III colon cancer: Results from Cancer and Leukemia Group B 89803
Abstract: BACKGROUND: Cigarette smoking has been shown to increase the risk of developing colorectal cancer, particularly smoking early in life. Little is known about the impact of tobacco use on colon cancer recurrence among colon cancer survivors. METHODS: The authors prospectively collected lifetime smoking history from stage III colon cancer patients enrolled in a phase 3 trial via self-report questionnaires during and 6 months after completion of adjuvant chemotherapy. Smoking status was defined as never, current, or past. Lifetime pack-years were defined as number of lifetime packs of cigarettes. Patients were followed for recurrence or death. RESULTS: Data on smoking history were captured on 1045 patients with stage III colon cancer receiving adjuvant therapy (46% never smokers; 44% past; 10% current). The adjusted hazard ratio (HR) for disease-free survival (DFS) was 0.99 (95% confidence interval [CI], 0.70-1.41), 1.17 (95% CI 0.89-1.55), and 1.22 (95% CI 0.92-1.61) for lifetime pack-years 0-10, 10-20, and 20+, respectively, compared with never smoking (P = .16). In a preplanned exploratory analysis of smoking intensity early in life, the adjusted HR for 12+ pack-years before age 30 years for DFS was 1.37 (95% CI, 1.02-1.84) compared with never smoking (P = .04). The adjusted HR for DFS was 1.18 (95% CI, 0.92-1.50) for past smokers and 1.10 (95% CI, 0.73-1.64) for current smokers, compared with never smokers. CONCLUSIONS: Total tobacco usage early in life may be an important, independent prognostic factor of cancer recurrences and mortality in patients with stage III colon cancer. © 2010 American Cancer Society.
Keywords: adolescent; adult; cancer survival; controlled study; aged; aged, 80 and over; disease-free survival; middle aged; major clinical study; cancer recurrence; cigarette smoking; fluorouracil; cancer risk; cancer adjuvant therapy; cancer patient; disease free survival; cancer staging; prospective study; colorectal cancer; colonic neoplasms; risk factors; smoking cessation; recurrence; smoking; cancer mortality; self report; irinotecan; questionnaire; folinic acid; adjuvant chemotherapy; colon carcinoma; colon adenocarcinoma
Journal Title: Cancer
Volume: 116
Issue: 4
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2010-02-15
Start Page: 957
End Page: 966
Language: English
DOI: 10.1002/cncr.24866
PUBMED: 20052723
PROVIDER: scopus
PMCID: PMC2884300
DOI/URL:
Notes: --- - "Cited By (since 1996): 2" - "Export Date: 20 April 2011" - "CODEN: CANCA" - "Source: Scopus"
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  1. Leonard B Saltz
    599 Saltz