Association between smoking and tumor progression in Japanese women with adenocarcinoma of the lung

We studied the effect of smoking on tumor progression in 3312 patients with lung cancer registered at the National Matsudo Hospital and National Cance r Center Hospital East between 1977 and 1996. The odds ratios of the follow ing variables for tumor extent (localized versus advanced disease) and haza rd ratios for survival were calculated in both sexes separately using the l ogistic regression and Cox proportional hazard models, respectively: smokin g history, number of cigarettes smoked per day, pack-years smoked, age, his tological type, and the year of admission. Of the 943 women, 367 (38.9%) we re smokers and 694 (73.6%) had adenocarcinoma, whereas of the 2369 men, 225 5 (95.2%) were smokers and 1010 (42.6%) had adenocarcinoma. In female adeno carcinoma patients, the odds ratio (95% confidence interval) for advanced d isease and the hazard ratio (95 % confidence interval) for survival with an increase of 30 cigarettes smoked per day were 2.86 (1.49-5.49) and 1.52 (1 .13-2.04), respectively, but in those with non-adenocarcinoma, the odds rat io and hazard ratio were 0.96 (0.41-2.23) and 1.13 (0.75-1.70), respectivel y, In male patients, smoking history influenced tumor progression regardles s of histological type, but the odds ratios and hazard ratios were lower th an those for women with adenocarcinoma. In conclusion, smoking habit was cl osely correlated with progression of adenocarcinoma in women, This associat ion was not observed in women with non-adenocarcinoma and was weaker in men , suggesting various effects of smoking on lung cancer development dependin g on gender and the histological type of the tumor.