Objectives: About 90% of all non-small cell lung cancer (NSCLC) cases are associated with inhalative tabacco smoking. Half of patients continue smoking during lung cancer therapy. We examined the effects of postoperative smoking cessation on lung function, quality of life (QOL) and long-term survival. Materials and Methods: In total, 641 patients, who underwent lobectomy between 2012 and 2019, were identified from our single institutional data base. Postoperatively, patients that actively smoked at the time of operation were offered a structured ‘smoking cessation’ program. For this retrospective analysis, two patient groups (totaln= 90) were selected by pair matching. Group A (n= 60) had no postoperative tobacco smoking. Group B (n= 30) involved postoperative continued smoking. Lung function (FEV1, DLCO) and QOL (‘SF-36′ questionnaire) were measured 12 months postoperatively. We compared long-term outcomes using Kaplan–Meier curves. Results: The mean age in group A was 62.6 ± 12.5 years and that in group B was 64.3 ± 9.7 years (p= 0.82); 64% and 62%, respectively, were male (p= 0.46). Preoperative smoking habits were similar (‘pack years’: group A, 47 ± 31; group B, 49 ± 27;p= 0.87). All relevant baseline characteristics we collected were similar (p> 0.05). One year after lobectomy, FEV1 was reduced by 15% in both groups (p= 0.98). Smoking cessation was significantly associated with improved DLCO (group A: 11 ± 16%; group B: −5 ± 14%;p<0.001) and QOL (vitality (VT): +10 vs. −10,p= 0.017; physical role function (RP): +8 vs. −17,p= 0.012; general health perceptions (GH): +12 vs. −5,p= 0.024). Patients who stopped smoking postoperatively had a significantly superior overall survival (median survival: 89.8 ± 6.8 [95% CI: 76.6–103.1] months vs. 73.9 ± 3.6 [95% CI: 66.9–80.9] months,p= 0.034; 3-year OS rate: 96.2% vs. 81.0%,p= 0.02; 5-year OS rate: 80.0% vs. 64.0%,p= 0.016). The hazard ratio (HR) was 2.31 [95% CI: 1.04–5.13] for postoperative smoking versus tobacco cessation. Conclusion: Postoperative smoking cessation is associated with improved quality of life and lung function testing. Notably, a significant increase in long-term survival rates among non-smoking NSCLC patients was observed. These findings could serve as motivation for patients to successfully complete a non-smoking program.
目的：约90%的非小细胞肺癌（NSCLC）病例与吸入性烟草使用相关。半数患者在肺癌治疗期间仍持续吸烟。本研究旨在探讨术后戒烟对肺功能、生活质量（QOL）及长期生存率的影响。材料与方法：从本机构数据库中筛选2012年至2019年间接受肺叶切除术的641例患者。术后为术中仍在吸烟的患者提供结构化“戒烟”计划。通过配对匹配选取两组患者（总计n=90）进行回顾性分析：A组（n=60）术后完全戒烟，B组（n=30）术后持续吸烟。术后12个月测量肺功能（FEV1、DLCO）及生活质量（采用SF-36量表），并通过Kaplan-Meier曲线比较长期结局。结果：A组平均年龄62.6±12.5岁，B组64.3±9.7岁（p=0.82）；男性比例分别为64%与62%（p=0.46）。术前吸烟史相似（吸烟指数：A组47±31包年，B组49±27包年，p=0.87）。所有基线特征均无统计学差异（p>0.05）。肺叶切除术后1年，两组FEV1均下降15%（p=0.98）。戒烟与DLCO改善显著相关（A组：+11±16%；B组：-5±14%；p<0.001），且生活质量显著提升（活力维度：+10 vs. -10，p=0.017；生理职能维度：+8 vs. -17，p=0.012；总体健康维度：+12 vs. -5，p=0.024）。术后戒烟患者总生存期显著延长（中位生存期：89.8±6.8个月[95%CI:76.6-103.1] vs. 73.9±3.6个月[95%CI:66.9-80.9]，p=0.034；3年生存率：96.2% vs. 81.0%，p=0.02；5年生存率：80.0% vs. 64.0%，p=0.016）。术后持续吸烟与戒烟相比的风险比（HR）为2.31[95%CI:1.04-5.13]。结论：术后戒烟与生活质量及肺功能检测指标的改善相关。值得注意的是，戒烟的非小细胞肺癌患者长期生存率显著提高。这些发现可为患者成功完成戒烟计划提供重要激励。
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